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Why Desired Newborn Circumcisions Are Not Performed: A Survey
Richard Otto1, Grant Evans1, Christopher Boniquit1
1Department of Urology, University of Texas Health Science Center at San Antonio, San Antonio, TX.
Insights
Many parents miss the newborn circumcision (NBC) window due to hospitals not offering the procedure or provider unavailability. Ineffective communication and health issues also contribute to delays in desired infant circumcisions.
Area of Science:
- Pediatric Urology
- Public Health
Background:
- Newborn circumcision (NBC) is a common procedure with a limited window for performance.
- Delayed circumcision often necessitates operating room procedures, increasing costs and risks.
Purpose of the Study:
- To determine why parents who desire newborn circumcision (NBC) do not have the procedure performed within the recommended timeframe.
- To identify barriers preventing timely NBC and inform strategies for improvement.
Main Methods:
- A survey was conducted with 104 parents who sought circumcision for their sons.
- Two groups were surveyed: those seeking NBC for infants under 1 month and those seeking circumcision for children aged 1 month to 2 years.
- Participants were asked why NBC was not performed in the hospital.
Main Results:
- The primary reasons for not performing NBC were the hospital not offering the procedure (20-23%) and unavailability of the provider (20-21%).
- Ineffective communication delayed NBC in 26% of younger infants, while health problems delayed it in 30% of older infants.
- Parental indecision was a minimal factor, cited in only 2-6% of cases.
Conclusions:
- Barriers to timely newborn circumcision (NBC) include systemic issues like inadequate preparation, resource limitations, and poor communication within healthcare settings.
- Streamlining the process for desired NBC is crucial to ensure parents can access the procedure within the optimal window.
Objective:
To identify why parents who want their child circumcised do not have them circumcised before the window for newborn circumcision (NBC) closes. We evaluate many patients in our pediatric urology clinic for circumcision in the operating room, which is associated with increased inconvenience, morbidity, and cost.
Methods:
From 2010 to 2013 we surveyed 53 parents seeking NBC for their sons less than 1 month old. We surveyed a second group of 51 parents with sons between 1 month and 2 years old seeking operating room circumcision. Both groups were asked why NBC was not performed in the hospital.
Results:
From the 104 parents surveyed, the primary reasons NBC was not performed in both groups were that the hospital did not offer or provide NBC (23% in the younger group and 20% in the older group) and that the provider who does NBC was not available or able prior to discharge (21% in the younger group and 20% in the older group). Ineffective communication delayed NBC in 26% of the younger group and 9% of the older group. Health problems delayed NBC in 8% of the younger group and 30% of the older group. NBC was only delayed due to parent indecision in 2% of responses in the younger group and 6% in the older group.
Conclusion:
Inadequate healthcare system preparation, resources, and communication are the primary reasons NBC is delayed. More work to streamline the process for desired NBC is needed.
