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Circumcision in Hemophilia: A Multicenter Experience
Osama A Bawazir1,2, Ibrahim Alharbi3
1Departments of Surgery.
Journal of Pediatric Hematology/Oncology
|October 1, 2020
Summary
Circumcision is possible for hemophilia patients, but requires careful management. While bleeding complications are infrequent, they can be serious, necessitating specialized care in hemophilia centers.
Area of Science:
- Pediatric Surgery
- Hematology
Background:
- Social pressures often lead hemophiliac patients and families to consider circumcision.
- Potential complications associated with circumcision in hemophiliacs necessitate careful consideration.
Purpose of the Study:
- To document the experience and outcomes of circumcising patients with hemophilia.
- To evaluate the safety and feasibility of circumcision in this specific patient population.
Main Methods:
- A retrospective review of 35 hemophilia patients undergoing circumcision across three centers (2010-2019).
- Patients ranged from 0.3 months to 8 years old, with varying degrees of Hemophilia A (mild, moderate, severe).
- Prophylactic treatment involved two doses of factor VIII concentrate (50μ/kg) pre- and post-procedure.
Main Results:
- Four neonates were diagnosed with hemophilia post-circumcision due to bleeding.
- Post-discharge bleeding occurred in 6.5% of severe Hemophilia A patients, requiring additional factor concentrate.
- Wound complications included gaping (6.5%) and infection (3.2%).
Conclusions:
- Hemophilia is not an absolute contraindication for circumcision.
- Circumcision in hemophilic children should be performed in specialized hemophilia centers with appropriate protocols.
- While bleeding is not frequent, it can be serious and requires vigilant management.
