Male Circumcision Complications – A Systematic Review, Meta-Analysis and Meta-Regression

Shabanzadeh, Daniel Mønsted; Clausen, Signe; Maigaard, Katrine; Fode, Mikkel

doi:10.1016/j.urology.2021.01.041

Cited by 30 publications

(22 citation statements)

References 22 publications

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“…However, this view has view criticized on several grounds. First, although the risk of surgical complications associated with PC appears to be lower, on average, in infancy compared to PC later in childhood, it does not appear to be significantly lower than circumcision performed consensually in adulthood, when compliance with wound-care can be more readily assured [ 12 ]. Also as the hypothetical example of cosmetic “infant labiaplasty” shows, the surgical alteration of anatomically typical, non-diseased genital tissues is, in other contexts, considered to be categorically impermissible if done without the informed consent of the affected individual [ 13 ].…”

Section: Perspectivementioning

confidence: 99%

Is it time for a time-out? Progress versus politics in studying the psychosexual implications of penile circumcision

Marco

2022

Int J Impot Res

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Tye and Sardi present an extensive critical overview of the sparse and inconsistent literature on the psychological, psychosocial, and psychosexual impact of penile circumcision (PC) with a clear aim of achieving a framework for policy considerations and future research. With this perspective I humbly propose to step back and ask some deeper questions about PC, being this a politicized topic we should ask ourselves whether we can engage with a literature so full of polemical publications and polarized opinions. Even when presenting “straightforward” empirical data we can stimulate very different interpretations based on the previous beliefs or convictions of the reader, generating an undesirable sociocultural division. While PC is becoming a hot topic, we are falling far from reaching a consensus towards a medical policy framework to counsel families and individuals searching for answers; it actually seems to become a politicised philosophical battle between medical and health providers, researchers, psychologists, anthropologists, and activists. At this point, can we disentangle this ball of twine, asking the same questions and searching for the same answers—or should we call for a time-out and revaluate what we want to figure out about human sexuality in relation to cultural modifications of the genitals?

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Section: Perspectivementioning

confidence: 99%

Is it time for a time-out? Progress versus politics in studying the psychosexual implications of penile circumcision

Marco

2022

Int J Impot Res

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“…Results of a recent meta-analysis indicated that overall risk of complications requiring treatment after male circumcisions was 3.84% (95% confidence interval 3.35-4.37) [7]. According to some authors, a lower frequency of complications is observed when the procedure is performed on newborns; others believe that the difference is caused by a better documentation of adverse events in older patients.…”

Section: Clinical and Medical Case Reportsmentioning

confidence: 99%

Foreskin Retraction and Circumcision: Possible Late Consequences

Jargin¹

2021

J Clin Med Case Reports

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This case report is about spontaneous foreskin retraction but it is relevant also to the status after circumcision. Non-therapeutic male circumcision remains controversial; there is evidence in support of its benefits; however, good hygiene may achieve some of the aims. Late consequences are understudied, in particular, those related to atrophy of the ageing genital skin and mucous membranes. A superficial scald burn of the genital area occurred to a 3-years-old boy in conditions of child neglect. Immediate medical help was not sought. In the following years, symptoms of balanoposthitis were repeatedly noticed. Along with the pubertal development, the foreskin became completely and permanently retracted. There has never been any strangulation or compression in terms of paraphimosis. The symptoms started appearing at the age of about 58 years: recurring superficial erosions in the frenular area, preputial rim and adjacent surfaces. The penis binding with a soft cloth and occasional topical treatment is necessary as atrophic skin is sensitive and vulnerable. Derangements of blood supply may contribute to atrophic changes; therefore, vascular diseases and diabetes mellitus must be included in the differential diagnosis. Potential adverse effects discussed in this report emphasize the fact that non-therapeutic neonatal circumcision is an invasive procedure performed without patients' consent.

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“…MC in adults is mainly performed through sleeve resection, forceps-guided, and dorsal slit methods [ 12 ]. However, these traditional approaches are tedious and could lead to complications such as peri-/postoperative pain, bleeding, and infection [ 13 , 14 , 15 ]. Thus, novel methods and devices have been developed to overcome these adverse events to improve circumcision effectiveness with enhanced safety.…”

Section: Introductionmentioning

confidence: 99%

A Retrospective Taiwanese-Population-Based Clinical Study on Determining the Efficacy and Safety of Disposable Circumcision Anastomat

Chou

Laih

2022

JCM

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Traditional approaches for male circumcision are tedious and could lead to complications such as peri-/postoperative pain, bleeding, and infection. Thus, for the first time, we investigated the surgical outcomes of recently the discovered Disposable Circumcision Anastomat Type A (Dongguan ZSR Biomedical Technology Company Ltd., China), a disposable circumcision suture device (DCSD), in terms of the operation time, surgical complexity, safety, satisfaction, and aesthetic outcomes and most importantly the prognostic factors for postoperative infection. A total of 394 individuals were circumcised, with a mean age, body mass index (BMI), stretched penile length (SPL), and penile circumference of 30.1 ± 7.05 years, 25.47 ± 4.73, 10.12 ± 1.61, and 7 ± 0.73 cm, respectively. Associated comorbidities included diabetes mellitus (6.09%), hypertension (2.03%), gout (1.02%), end-stage renal disease (ESRD, 0.25%), and HIV (0.25%). The mean operation time, average postoperative bleeding, and wound infection rate was 31.4 ± 9.96 min, 2.54%, and 9.39%, respectively. The mean VAS postoperative pain scores at D0 and D1 were 4.4 ± 2.4 and 1.9 ± 1.6, respectively. Moreover, 1.27% of subjects required reoperation, and a 2.03% rate of instrument malfunction was noted. The significant factors associated with the post-operative infection group were age (p = 0.0313), BW (p = 0.0081), BMI (p = 0.0026), penile circumference (p = 0.0343), and DM (p ≤ 0.001). Multivariate analyses revealed only DM as a statistically significant factor (p < 0.001). Our box–whisker plot revealed no significant difference between the HbA1c level of infection (Hb1Ac = 7.77 ± 1.39) and non-infection groups (Hb1Ac = 6.92 ± 1.84). However, a trend of higher glycemic index in the infection group was observed. Conclusively, DSCD could be an effective and safe alternative to performing circumcision. However, in the population with advanced aging, phimosis, elevated BMI, and DM (HbA1C > 9%), users should be highly cautious due to the increased risk of infection, dehiscence, and hematoma.

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Male Circumcision Complications – A Systematic Review, Meta-Analysis and Meta-Regression

Cited by 30 publications

References 22 publications

Is it time for a time-out? Progress versus politics in studying the psychosexual implications of penile circumcision

Is it time for a time-out? Progress versus politics in studying the psychosexual implications of penile circumcision

Foreskin Retraction and Circumcision: Possible Late Consequences

A Retrospective Taiwanese-Population-Based Clinical Study on Determining the Efficacy and Safety of Disposable Circumcision Anastomat

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