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Acute obstructive uropathy--a rare complication of circumcision
J C Craig1, W G Grigor, J F Knight
1Department of Nephrology, Royal Alexandra Hospital for Children, Camperdown, Sydney, NSW, Australia.
European Journal of Pediatrics
|May 1, 1994
Summary
A rare complication of ritual circumcision led to acute urinary obstruction and renal impairment in an infant. This case highlights the potential for severe obstructive uropathy following foreskin removal.
Area of Science:
- Pediatric Surgery
- Urology
- Nephrology
Background:
- Ritual circumcision is a common procedure in male infants.
- Urinary retention is a known, albeit uncommon, complication of circumcision.
Observation:
- An 8-week-old boy developed reduced urine output and a distended bladder one week post-circumcision.
- Ultrasonography revealed bilateral hydroureteronephrosis, indicating partial urinary obstruction.
- The obstruction was attributed to the post-surgical dressing and glans edema.
Findings:
- The infant presented with abnormal renal function, including elevated creatinine and urea.
- Hyperkalemic metabolic acidosis with hyponatremia was observed, consistent with obstructive uropathy.
- Prolonged secondary bladder dysfunction necessitated urinary catheterization for one week.
Implications:
- This case represents the first report of significant obstructive uropathy and renal impairment secondary to surgical excision of the foreskin.
- It underscores the importance of vigilant monitoring for urinary complications after circumcision, even in the absence of typical signs.
- Further awareness and potentially revised post-operative care protocols may be warranted to prevent such rare but severe outcomes.