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Published on: June 3, 2022
Systematic review of complications arising from male circumcision
Stanca Iris Iacob1, Richard S Feinn1, Lauren Sardi2
1Frank H. Netter MD School of Medicine Quinnipiac University North Haven Connecticut USA.
Insights
Complications from neonatal male circumcision are frequent. Healthcare providers should be better informed to counsel patients on risks and prevention strategies for this common surgical procedure.
Area of Science:
- Pediatric Surgery
- Urology
- Public Health
Background:
- Neonatal male circumcision is a globally prevalent surgical procedure.
- It is the most common procedure performed on pediatric patients worldwide.
Purpose of the Study:
- To systematically review and compile complications associated with male circumcision surgeries.
- To inform healthcare providers about potential risks and prevention strategies.
Main Methods:
- A comprehensive literature search was conducted on PubMed using the term 'male circumcision'.
- 6,641 articles published between 1945 and 2020 were identified, with 78 selected for systematic review.
- Articles were categorized into complication rates, specific complications, and physician/society recommendations.
Main Results:
- A total of 47 distinct complications arising from male circumcision surgeries were identified.
- Complication rates were reported in 15 articles (chart reviews, cohort studies).
- Specific complications were detailed in 51 case reports and series.
Conclusions:
- Complications following neonatal male circumcision are common.
- Enhanced provider knowledge is crucial for effective patient counseling on risks and prevention.
- Informed parental decision-making, considering provider experience and setting, is essential.
Background:
Neonatal male circumcision is the most common procedure performed on paediatric patients (Simpson et al., 2014) and one of the most common surgical procedures in the world (American Academy of Pediatrics, 2012).
Methods:
A search was conducted for articles about complications arising from male circumcision surgeries by entering the term 'male circumcision' into PubMed on June 16, 2020. Six thousand six hundred forty-one articles published from 1945 to 2020 were found. Seventy-eight articles were ultimately selected for the systematic review.
Results:
The 78 articles selected from the literature search were entered into one of three tables. The first table includes 15 articles pertaining to chart reviews and cohort studies and report complication rates. The second table reports specific complications from 51 case reports and case series, and the third table is a summary from 12 articles regarding physician questionnaires and society recommendations. Additionally, the 78 articles were used to compile a list of 47 specific complications arising from male circumcision surgeries.
Conclusions:
Complications from neonatal male circumcisions are common and healthcare providers need to be better informed of the potential complications of the surgery so that they can more effectively counsel their patients about potential risks, likelihood of complications and what can be done to prevent them. While experienced providers who practice in sterile settings have better outcomes with fewer complications, encouraging parents to take into account who is performing their son's circumcision, what was their training, how clean is their practice and how much experience they have and reminding them they have the option to decline the procedure entirely allow the parents to get a more complete picture and play an essential role in the decision-making process.
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