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Experience and outcomes for PAs in a neonatal circumcision clinic
Kaity Colón-Sanchez1, Tiernan Middleton, Pamela Ellsworth
1Kaity Colón-Sanchez practices in the Division of Urology at Nemours Children's Hospital in Orlando, Fla. Tiernan Middleton is a resident at the University of Maryland Medical Center in Baltimore, Md. Pamela Ellsworth is division chief at Nemours Children's Hospital in Orlando. The authors have disclosed no potential conflicts of interest, financial or otherwise.
Objective:
To evaluate the outcomes of neonatal circumcision performed by a PA in pediatric urology.
Methods:
A retrospective review was performed of infants evaluated for neonatal circumcision by a single PA in pediatric urology over 30 months. Technique, age and weight at circumcision, presence or absence of genital anomalies, and complications were gathered.
Results:
Of the 371 male infants evaluated for neonatal circumcision, 276 underwent the procedure. Complications included retained Plastibell (2.1%), penile adhesions (1.1%), swelling (1.8%), and cosmetic concerns (0.73%). Eighteen unanticipated postprocedure visits occurred-four in the ED and 14 in the outpatient clinic. No acute procedural complications occurred. One patient (0.3%) underwent lysis of penile adhesions at age 19 months.
Conclusion:
Neonatal circumcisions are commonly performed by nonsurgeons with variable formal circumcision training. These data support that well-trained PAs can perform neonatal circumcisions with low complication rates.
