Complications Associated With Circumcision in a Community-Based Hospital

Infant male circumcision is a common elective procedure in the United States. Complications include bleeding, glans injury, insufficient or excessive skin removal, and adhesions. We assessed percentages and factors associated with complications of circumcisions at our community-based hospital from 2010 to 2020.

We conducted a retrospective cohort study of male infant patients who had circumcisions performed in the Kaiser Permanente Woodland Hills (KPWH) Medical Center from January 1, 2010, to January 1, 2020. Complications were measured through emergency room visits up to 24 hours postcircumcision, complication codes, and referral appointments to urology within 2 years of age.

Of the total patients (N=2,715), 1.4% were referred to urology for potential complications, and 0.3% required revision surgery. Weight and age at the time of the circumcision and the location of the circumcision (hospital vs clinic) did not have a significant effect on the complication rate. Infants who had a circumcision with a Mogen clamp had an increased percentage of complications compared to the Gomco clamp (2% compared to 0.9%). The number of complications requiring surgery decreased (from 0.4% to 0.17%) when our hospital limited those physicians performing circumcisions by requiring 20 circumcisions per year to maintain privileges.

Infant male circumcision is a safe procedure whether performed in the hospital or clinic. Complications likely can be reduced if circumcisions are completed by physicians who perform them regularly. Further studies are needed to investigate the difference between Mogen and Gomco clamp outcomes.