Complications of circumcision
This directory contains articles about the complications,
risks, adverse effects, and disadvantages of circumcision and
their treatments (not including repair of the circumcision
itself; see Foreskin
reconstruction). See also Psychological
Impacts of Circumcision.
|
[A] Urethral fistula at frenulum
(note probe), probably the result of incisional
trauma. [B] Three-year-old boy with an almost
transected glans from circumcision at birth, but
parents did not note the abnormality until age 3.
Urethra had been completely transected (arrow). [C]
Neonate referred immediately after Gomco clamp
circumcision in which all the skin of the shaft had
been amputated. This is a fairly common complication
caused by pulling too much skin up into the clamp and
amputating it. Fortunately sometimes there is enough
of the mucosal side of the prepuce to fold back to
resurface the shaft, but some require a free skin
graft. [D] Six-month-old baby was referred after loss
of the entire penis from cautery used during
circumcision. Evidently both corpora had thrombosed
and sloughed, so no phallus remained. |
| (From the textbook Pediatric
Trauma, edited by Robert J. Touloukian, M.D.,
Yale University School of Medicine (John Wiley &
Sons). |
Medical journal articles about complications are divided
into case reports, propective studies, retrospective studies,
and literature survey articles. Case reports report
individual cases. Prospective studies are forward looking
studies that record the complications experienced by a
particular group of infants. Retrospective studies look
backward by examination of medical and/or hospital records.
Survey articles provide a summary of the existing medical
literature.
Case report articles provide information about the variety
and incidence of complications of circumcision but do not
provide information on the total number of complications that
result from circumcision. Cases are reported only when the
complication has not been previously seen or when new
information can be added to the store of medical knowledge of
treatment or management.
The incidence of complications, risks, and adverse effects
of male circumcision is controversial. There is wide
disagreement on what constitutes a complication. Some studies
only record immediate in hospital complications, while other
studies record complications that occur later in life.
Needless to say, these variations cause a wide range in the
reported incidence of complications. None of the available
prospective studies consider the sexual effects of male
circumcision in adult life. The National Organization to Halt
the Abuse and Routine Mutilation of Males (NOHARMM) has
compiled statistical
data on the estimated total number of complications and
has made it available on the World Wide Web.
Williams and Kapila estimate that a realistic rate of
complications from neonatal circumcision ranges from 2% to
10%. To many men who become aware of the function and value
of the prepuce, the fact that this genital sensory organ
was amputated from them at birth is itself a complication
of circumcision; in which case, the actual complication
rate is 100%... For males fortunate enough to survive the
surgery without immediate complications, there is a growing
awareness among men of other delayed, long-term
consequences of neonatal circumcision, which are only now
beginning to be documented.
--Awakenings (NOHARMM)
Prospective Studies of Circumcision Complications
Prospective studies of circumcision complications are
controlled studies of the type and number of complications of
circumcision that occur in a clinical setting. CIRP provides
studies from Canada, England, New Zealand, Turkey, and the
United States. Prospective studies usually provide
information on the incidence (percentage of boys suffering
adverse effects) of complications. Reported rates of
complications range up to 55%.
- Patel H. The
problem of routine infant circumcision. Can. Med.
Assoc. J. (Sept 10, 1966); 95: 576-581.
- Metcalf TJ, Osborn LM, Mariani EM. Circumcision:
a study of current practices. Clin Pediatr
(Phila) 1983; 22: 575-579.
- Leitch IOW. Circumcision
- a continuing enigma. Aust Paediatr J
1970;6:59-65.
- Griffiths DM. Atwell JD. Freeman NV.
A prospective survey of the indications and morbidity of
circumcision in children. European Urology
1985;11(3):184-7.
- Fergusson DM, Lawton JM, Shannon FT.
Neonatal circumcision and penile problems: an 8-year
longitudinal study. Pediatrics 1988; 81:
537-41.
- Ozdemir E. Significantly
increased complication risk with mass circumcisions.
Brit J Urol, Vol 80, Pages 136-139, August
1997.
- Van Howe RS. Variability in
penile appearance and penile findings: a prospective
study. Brit J Urol 1997;80:776-782.
- Mayer E, Caruso DJ, Ankem M, et al. Anatomic variants
associated with newborn circumcision complications.
Can J Urol 2003;10(5):2013-6.
- Corbett HJ, Humphrey GME. Early complications
of circumcisions performed in the community. Br J
Gen Pract 2003;53(496):887-8.
- Machmouchi M, Alkhotani A. Is
neonatal circumcision judicious? Eur J Pediatr
Surg 2007;17:266-9.
Retrospective Studies
Retrospective studies examine medical records. In a small
retrospective study limited to the incidence of adhesions in
circumcised boys, Gracely-Kilgore reported that 15 percent of
circumcised boys experience adhesions. Three percent required
surgical correction. El-Bahnasawy reported that circumcision
is the most frequent cause of penile injury.
- Gracely-Kilgore KA. Penile adhesion:
the hidden complication of circumcision. Nurse
Pract 1984; 9: 22-4.
- Ahmed A, Mbibi NH, Dawam D, Kalayi GD. Complications of
traditional male circumcision. Ann Trop Paediatr
1999;91(1):113-7.
- El-Bahnasawy MS, El-Sherbiny MT.
Penile pediatric trauma. BJU Int
2002;90:92-96.
- Perovic SV. Severe penile
injuries: etiology, management and outcomes. Urol
Pol 2005;58(3):
Survey Articles
Survey articles survey the medical literature. They
provide a summary of the literature. CIRP provides two of the
best.
- Kaplan GW. Complications
of circumcision. Urol Clin N Amer
1983;10:543-549.
- Williams N, Kapila L. Complications of circumcision.
Br J Surg 1993; 80:1231-36.
Case reports
Case reports are reports of individual cases that have
appeared in the medical literature regarding complications of
circumcision. The list provided here is extensive but it is
not comprehensive. There are other reports that are not
listed here.
Ablation of the Penis
- Brown JB, Fryer MP. Surgical reconstruction
of the penis. GP 1958; 17: 104-7.
- Money, John. Ablatio Penis: Normal Male Infant
Sex-Reassigned As A Girl Archives of Sexual Behavior
(New York) vol. 4 no. 1 January 1975 pp. 65-71
- Pearlman CK. Reconstruction following iatrogenic burn
of the penis. J Pediatr Surg 1976;11:121-2.
- Pearlman CK. Caution advised on electrocautery
circumcisions. Urology 1982;19:453.
- Gearhart JP, Rock JA. Total Ablation of
The Penis After Circumcision With Electrocautery: A Method
Of Management and Long-term Followup. Journal of
Urology (Baltimore) vol. 142 no. 3 September 1989 pp.
799-801.
- Stefan, H. Reconstruction of the Penis Following
Necrosis from Circumcision Used High Frequency Cutting
Current. Sbornik Vedeckych Praci Lekarske Fakulty
Karlovy Univerzity (Hradci Kralove) vol. 35, no. 5
(Suppl) 1992, pp. 449-454.
- Gilbert DA, Jordan GH, Devine CJ Jr, Winslow BH,
Schlossberg SM. Phallic construction in prepubertal and
adolescent boys. J Urol 1993; 149: 1521-6.
- Bradley SJ, Oliver GD, Chernick AB. Experiment of
Nurture: Ablatio Penis at 2 Months, Sex Reassignment at 7
Months, and a Psychosexual Follow-up in Young
Adulthood. Pediatrics 1998;102(1):e9.
- Marks MB. Preputial adhesions in the
circumcised penis. Arch Pediatr 1939; 56:
458-9.
- Gracely-Kilgore KA. Penile adhesion:
the hidden complication of circumcision. Nurse
Pract 1984; 9: 22-4.
- Attalla MF, Taweela MN. Pathogenesis of
post-circumcision adhesions. Pediatr Surg Int 1994;
9: 103-5.
- Ponsky LE, Ross JH, Knipper N, Kay R. Penile adhesions
after neonatal circumcision. J Urol
2000;164(2):495-6.
Amputation of the penis
- Brimhall JB. Amputation of the penis
following a unique method of preventing hemorrhage after
circumcision. St Paul Med J 1902; 4: 490.
- Lerner BL. Amputation of the penis as a complication of
circumcision. Med Rec Ann 1952;46:229-31.
- Levitt SB, Smith RB, Ship AG. Iatrogenic
microphallus secondary to circumcision. Urology
1976; 8: 472-4.
- Izzidien AY. Successful
replantation of a traumatically amputated penis in a
neonate. Journal of Pediatric Surgery April
1981,16(2):202-203.
- Hanash KA. Plastic
reconstruction of partially amputated penis at
circumcision. Urology 1981; 18(3): 291-3.
- Azmy A, Boddy SA, Ransley PG. Successful reconstruction
following circumcision with diathermy. Br J Urol
1985; 57: 587-8.
- Yilmaz AF, Sarikaya S, Yildiz S, et al. Rare
complication of circumcision: penile amputation and
reattachment. European Urology (Basel) 1993; 23(3):
423-424.
- Audry G, Buis J, Vazquez MP, Gruner M. Amputation of penis after
circumcision--penoplasty using expandable prosthesis.
Eur J Pediatr Surg 1994; 4: 44-5.
- Hanukoglu A, Danielli L, Katzir Z, Gorenstein A, Fried
D. Serious complications of routine ritual circumcision in
a neonate: hydro ureteronephrosis, amputation of glans
penis, and hyponatraemia. Eur J Pediatr 1995; 154:
314-5.
- Gluckman GR et
al. Newborn
Penile Glans Amputation During Circumcision and Successful
Reattachment. Journal of Urology (Baltimore),
vol. 153 no. 3 Part 1 March 1995 pp. 778-779.
- Strimling BS. Partial amputation
of glans penis during Mogen clamp circumcision.
Pediatrics 1996; 97: 906-7.
- Neulander E, Walfisch S. Kaneti J. Amputation of distal
penile glans during neonatal ritual circumcision -- a rare
complication. Br J Urol 1996; 77: 924-5.
- Sherman J, Borer JG, Horowitz M, Glassberg KI. Circumcision:
successful glanular reconstruction and survival following
amputation. J Urol 1996; 156: 842.
- Van Howe RS. Re: circumcision: successful glanular
reconstruction and survival following traumatic amputation
(Letter). J Urol. 1997;158:550.
- Coskunfirat OK, Sayiklkan S, Velidedeoglu H.. Glans and
penile skin amputation as a complication of circumcision
(letter). Ann Plast Surg 1999;43(4):457.
- Siegel-Itzkovich J. Baby's
penis reattached after botched circumcision. BMJ
2000;321:529.
- Park JK, Min JK, Kim HJ. Reimplantation of an amputated
penis in prepubertal boys. J Urol
2001;165:586-7.
Anesthesia
- Sara CA, Lowry CJ. A complication of
circumcision and dorsal nerve block of the penis.
Anaesth Intensive Care 1985; 13: 79-82.
- Berens R, Pontus SP Jr A complication associated with
dorsal penile nerve block. Reg Anesth 1990; 15:
309-10.
- Snellman LW, Stang HJ. Prospective evaluation of
complications of dorsal penile nerve block for neonatal
circumcision. Pediatrics 1995; 95: 705-708.
- Tse S, Barrington K. Methemoglobinemia associated with
prilocaine use in neonatal circumcision. Am J
Perinatol 1995; 12: 331.
- Arda IS, Özbek N, Akpek NE and Ersoy E. Toxic
neonatal methaemoglobinaemia after prilocaine
administration for circumcision. BJU Int
2000;85(9):1-1.
- Couper RTL. Methaemoglobinaemia
secondary to topical lignocaine/prilocaine in a circumcised
neonate. J Paediatr Child Health
2000;36(4):406-407.
- Odemis E, Sonmez FM, Aslan Y. Toxic
methemoglobinemia due to prilocaine injection after
circumcision. Int Pediatr 2004;19(2):96-7.
Apnea
- Fleiss PM, Douglass J. The
case against neonatal circumcision. Brit Med J
1979;2(6189):554.
- Lander J, Brady-Freyer B, Metcalfe JB, et al. Comparison
of ring block, dorsal penile nerve block, and topical
anesthesia for neonatal circumcision. JAMA 1997;
278:2158-2162.
Autism Spectrum Disorder
A medical paper published in May 2013 reported a
correlation between the increased use of paracetamol
(acetominophen) as an analgesic for circumcision pain and
an increase in autism spectrum disorder. While correlation
does not prove that paracetemol causes autism
spectrum disorder, it does raise concerns that it may.
Parents may wish to avoid increasing the potential risk of
autism spectrum disorder by avoiding circumcision.
- Bauer AZ, Krieger D. Prenatal and perinatal analgesic
exposure and autism: an ecological link.
Environ Health 2013 May 9;12:41. doi:
10.1186/1476-069X-12-41.
Bleeding and Hemorrhage
[CIRP Comment: No one knows if a
newborn baby has a bleeding disorder. Although circumcision
cuts through arteries and veins that provide blood to the
foreskin, it is not customary to do a clotting factor test
prior to circumcision. If a bleeding disorder exists it will
be discovered only during the course of the
operation.
Post-circumcision bleeding is an
extremely serious matter. Substantial bleeding cannot be
tolerated, because the quantity of blood is an infant's body
is quite small. Bleeding can lead to exsanguination, followed
by hypovolemic shock, followed by death. Post-circumcision
bleeding requires immediate medical
attention.]
- Shulman J, Ben-hur N, Neuman Z. Surgical
complications of circumcision. Am J Dis Child 1964;
107:149-54.
- Patel H. The
problem of routine infant circumcision. Can. Med.
Assoc. J 95 (Sept 10, 1966): 576-581.
- Gee WF, Ansell, NF. Neonatal circumcision: a ten year
overview; with comparison of the Gomco clamp and the
Plastibell device. Pediatrics 1976; 58: 824-7.
- Kaplan GW. Complications of
circumcision. Urol Clin N Amer
1983;10:543-549.
- Griffiths DM. Atwell JD. Freeman NV.
A prospective survey of the indications and morbidity of
circumcision in children. European Urology 1985
11(3):184-7.
- Williams N, Kapila L.
Complications of circumcision. Br J Surg 1993;
80:1231-36.
- Killick CJ, Barton CJ, Aslam S, Standen GR. Prenatal
diagnosis in factor XIII-A deficiency. Arch Dis
Child Fetal Neonatal Ed 1999;80:F238-F239.
- Hiss J, Horowitz A, Kahana T. Fatal haemorrhage following
male ritual circumcision. J Clin Forensic Med
2000;7:32-4.
- Corbett HJ, Humphrey GME. Early complications
of circumcisions performed in the community. Br J
Gen Pract 2003;53(496):887-8.
- Newell TEC. Judgement of inquiry into the death of
McWillis, Ryleigh Roman Bryan. Burnaby, B.C.: British
Columbia Coroner's Service, Monday, 19 January 2004. [HTML
file]
Balanitis Xerotica Obliterans (BXO) secondary to
circumcision
- Stuehmer A. Balanitis xerotica obliterans
(post operationem) und ihre beziehungen zur "kraurosis
glandis et praeputii penis". Arch Derm Syph.
1928;156:613-23.
- Franks AG. Balanitis xerotica obliterans. J
Urol. 1946;56:243.
- Potter B. Balanitis xerotica obliterans manisfesting on
the stump of amputated penis. Arch Dermatol.
1959;79:473.
- Weigand DA. Lichen sclerosus et atrophicus, multiple
displastic keratosis and squamous cell carcinoma of the
glans penis. J Dermatol Surg Oncol. 1980;6
45-50.
- Campus GV, Ena P, Scuderi N. Surgical treatment of
balanitis xerotica obliterans. Plast Reconstr Surg.
1984;73(4):652-7.
- Zungri E, Chechile G, Algaba F, Mallo N. Balanitis
xerotica obliterans: surgical treatment. Eur Urol
1988;14:160-2.
- Garat JM, Checile G, Algaba F, Santaularia JM.
Balanitis xerotica obliterans in children. J Urol
1988;136:136-7
- Datta C, Dutta SR, Chaudhuri A. Histopathological and
immunological studies in a cohort of balanitis xerotica.
obliterans. J Ind Med Assoc1993;91 146-8.
Benign Prostatic Hyperplasia
- McCredie M, Staples M, Johnson W, et
al. Prevalence of urinary symptoms
in urban Australian men aged 40-69. J Epidemiol
Biostat 2001;6(2):211-8.
Botched Circumcisions
- McGowan AJ. A complication of
circumcision. JAMA 207(11) p. 2104, March
1969.
- Stefan H. Reconstruction of the penis following
necrosis from circumcision used high frequency cutting
current. Sb Ved Pr Lek Fak Karlovy Univerzity Hradci
Kralove Suppl 1992; 35: 449-54.
- Stefan H. Reconstruction of the penis after necrosis
due to circumcision burn. Eur J Pediatr Surg 1994;
4: 40-3.
- Patel HI, Moriarty KP, Brisson PA, Feirs NR. Genitourinary injuries in the newborn.
J Ped Surg 2001;36:235-239.
Buried, Concealed, and Hidden Penis
- Stewart DH. The toad in the
hole circumcision -- a surgical bugbear. Boston Med
Surg J 1924; 191: 1216-8.
- Talarico RD, Jasaitis JE. Concealed penis: a
complication of neonatal circumcision. J Urol
1973; 110: 732-3.
- Trier WC, Drach GW. Concealed penis.
Another complication of circumcision. Am J Dis
Child 1973; 125: 276-7.
- Radhakrishnan J, Reyes HM. Penoplasty
for buried penis secondary to "radical" circumcision.
J Pediatr Surg 1984;19: 629-31.
- Kon M. A rare
complication following circumcision: the concealed
penis. J Urol 1983; 130: 573-4.
- Donahoe PK, Keating MA. Preputial
unfurling to correct the buried penis. J Pediatr
Surg 1986; 21: 1055-7.
- Maizels M, Zaontz M, Donovan J, Bushnick PN, Firlit CF.
Surgical correction of the buried penis: description of a
classification system and a technique to correct the
disorder. J Urol 1986; 136: 268-73.
- Shapiro SR. Surgical
treatment of the "buried" penis. Urology 1987;
30: 554-9.
- Horton CE, Vorstman B, Teasley D, Winslow B. Hidden penis
release: adjunctive suprapubic lipectomy. Ann Plast
Surg 1987; 19: 131-4.
- van-der Zee JA, Hage JJ, Groen JM, Bouman FG. Een
ernstige complicatie ten gevolge van rituele circumcisie
van een 'begraven' penis. [A serious complication of ritual
circumcision of a 'buried' penis] Ned Tijdschr
Geneeskd 1991; 135: 1604-6.
- Bergeson PS. et
al. The
Inconspicuous Penis. Department of General Pediatrics
and Urology, Phoenix Children's Hospital. Pediatrics
1993;92:794-9.
- Alter GJ, Horton CE Jr; Horton CE Jr. Buried
penis as a contraindication for circumcision. J Am
Coll Surg 1994; 178: 487-90.
- Alter G. Buried Penis. (link to
http://www.altermd.com/pconstruct/urethral.htm)
- Blalock HJ, Vemulakonda V, Ritchey ML, Ribbeck M. Outpatient
Management of Phimosis Following Newborn Circumcision.
J Urol 2003;169(6):2332-4.
- Raboei L. Surgical management
of a concealed penis. Saudi Med J 2003
May;24(5):S50
- Sivakumar B, Brown AA, Kangesu L.
Circumcision in 'buried penis'--a cautionary tale.
Ann R Coll Surg Engl 2004;86(1):35-7.
Cancer, Post-Circumcision
- Bissada NK, Morcos RR, el-Senoussi M.
Post-circumcision carcinoma of the penis. I. Clinical
aspects. J Urol 1986 Feb;135(2):283-5.
- Bissada NK. Post-circumcision
carcinoma of the penis: II. Surgical management. J
Surg Oncol 1988;37(2):80-3.
Chilling
- Spence GR. Chilling
of newborn infants: its relation to circumcision
immediately following birth. South Med J 1970;
63: 309-11.
Chordee
- Kaplan GW. Circumcision: an overview.
Curr Probl Pediatr 1977 7:1-33.
Circulatory Complications
- Hamm WG, Kanthak FF. Gangrene of the penis
following circumcision with high frequency current.
South Med J 1949; 42: 657-9.
- Thorek P, Egel P. Reconstruction of the penis with
split-thickness skin graft: a case of gangrene following
circumcision for acute balanitis. Plast Reconst Surg
1949; 4: 469-72.
- Pinkham EW Jr, Stevenson AW Jr. Unusual reaction to
local anesthesia: gangrene of the prepuce. US Armed
Forces Med J 1958; 9: 120-2.
- Rosefsky JB Jr. Glans necrosis as a complication of
circumcision. Pediatrics 1967; 39: 774-6.
- du Toit DF, Villet WT. Gangrene of the
penis after circumcision: a report of 3 cases. S Afr
Med J 1979; 55: 521-2.
- Sterenberg N, Golan J, Ben-Hur N. Necrosis of the glans
penis following neonatal circumcision. Plast Reconstr
Surg 1981; 68: 237-9.
- Evbuomwan I, Aliu AS. Acute gangrene of
the scrotum in a one month old child. Trop Geogr
Med 1984; 36: 299-300.
- Ahmed S, Shetty SD, Anandan N, Patil KP, Ibrahim AIA.
Penile reconstruction following post-circumcision penile
gangrene. Pediatr Surg Int 1994; 9: 295-6.
- Kurel S. Iatrogenic penile gangrene: 10-year follow-up.
Plast Reconst Surg 1995; 95: 210-1.
- Aslan A, Karaguzel G, Melikoglu M. Severe ischemia of
the glans penis following circumcision: A successful
treatment via pentoxifylline. Int J Urol
2005;12(7):705-7.
Clamp Complications
- David
W. Feigal, Jr. Potential for Injury from
Circumcision Clamps. Rockville: U.S. Food and Drug
Administration, 2000.
Death
For more information on death as a
consequence of circumcision, see Circumcision Deaths.
- Holt LE. Tuberculosis acquired
through ritual circumcision. JAMA
1913;LXI(2):99-102.
- Reuben MS. Tuberculosis from
ritual circumcision. Proceedings of the New York
Academy of Medicine 1916; (December 15): 333-334.
- Rosenstein JL. Wound diphtheria
in the newborn infant following circumcision. J
Pediatr 1941;18:657-8.
- Gairdner D. The
fate of the foreskin. A study of circumcision.
BMJ 1949; 2: 1433-37.
- Scurlock JM, Pemberton PJ. Neonatal
meningitis and circumcision. Med J Aust
1977;1:332-334.
-
Cleary TG, Kohl S. Overwhelming
infection with group B beta-hemolytic streptococcus
associated with circumcision. Pediatrics, Vol
64, no 3, (September 1979), pp. 301-303.
- Dustin Evans, Jr., October 20,
1998(Link to www.noharmm.org)
- Hiss J., Horowitz A., Kahana T. Fatal haemorrhage following
male ritual circumcision. J Clin Forensic Med
2000;7:32-4.
- Newell TEC. Judgement of inquiry into the death of
McWillis, Ryleigh Roman Bryan. Burnaby, B.C.: British
Columbia Coroner's Service, Monday, 19 January 2004. [HTML
file]
- Paediatric Death Review Committee: Office of the Chief
Coroner of Ontario. Circumcision: a minor procedure?
Paediatr Child Health 2007;12(4):311-2
Denudation of the penile shaft
- Brown JB. Restoration of the entire skin of
the penis. Surg Gynecol Obstetr 1937; 65:
362-5.
- Wilson CL, Wilson MC. Plastic repair of
the denuded penis. South Med J 1959; 52:
288-90.
- Van Duyn J, Warr WS. Excessive penile
skin loss from circumcision. J Med Assoc Georgia
1962;51:394-6.
- Sotolongo JR Jr; Hoffman S, Gribetz ME. Penile denudation
injuries after circumcision. J Urol 1985; 133:
102-3.
- Smey P. Re: Penile denudation injuries after
circumcision. J Urol 1985; 134: 1220.
- Orozco-Sanchez J, Neri-Vela R. Denudacion total del
pene por circuncision. Descripcion de una tecnica de
plastia del pene para su correccion. [Total denudation of
the penis in circumcision: Description of a penoplasty
technique for its correction.] Bl Med Hosp Infant
Mex 1991; 48: 565-9.
Emesis
- Fleiss PM, Douglass J. The case against
neonatal circumcision. Brit Med J
1979;2(6189):554.
- Methemoglobinemia following neonatal
circumcision. JAMA 1989; 261: 702.
- Özbek N, Sarikayalar F. Toxic methaemoglobinaemia
after circumcision. Eur J Pediatr 1993; 152:
80.
- The
Canadian Nurse, August 1994, pp. 5-6.
- Tse S, Barrington K, Byrne P. Methemoglobinemia
associated with prilocaine use in neonatal circumcision.
Am J Perinatology 1995; 12: 331-2. Mandel S.
- Gazarian M, Taddio A, Klein J, Kent G, Koren G. Penile
absorption of EMLA cream in piglets: implications for use
of EMLA in neonatal circumcision. Biol Neonate 1995;
68: 334-41.
-
Physicians' Desk Reference, 1996, pp. 545-547.
- Özbek N, Akpek NE and Ersoy E. Toxic neonatal
methaemoglobinaemia after prilocaine administration for
circumcision. BJU International 2000, 85 (9),
1-1.
- Couper RTL. Methaemoglobinaemia
secondary to topical lignocaine/prilocaine in a circumcised
neonate. J Paediatr Child Health
2000;36(4):406-407.
Erotosexual complications
Please see Foreskin Sexual
Function/Circumcision Sexual Dysfunction for more
information on sexual complications of circumcision.
- Money J, Davison, J. Adult penile
circumcision: erotosexual and cosmetic sequelae. The
Journal of Sex Research, Vol 19 No. 3, pp. 289-292, August
1983.
Infection
[CIRP Comment: Methicillin resistant
staphylococcus aureus (MRSA) infection is becoming
increasingly found in epidemic proportions world wide. It may
be only a matter of time before newly circumcised boys in a
hospital nursery are infected with this antibiotic resistant
pathogen with life-threatening results. Staph infection can
cause arthritis, bacteremia, cellulitis, impetigo,
necrotizing fasciitis, pneumonia, osteomyletis,
staphylococcal pyoderma, staphylococcus scalded skin syndrome
(SSSS), and other diseases. Reassessment of the risk-benefit
ratio associated with non-therapeutic neonatal circumcision
urgently is necessary.]
- Holt LE. Tuberculosis acquired
through ritual circumcision. JAMA
1913;LXI(2):99-102.
- Reuben MS. Tuberculosis from
ritual circumcision. Proceedings of the New York
Academy of Medicine 1916; (December 15): 333-334.
- Reuben MS. Tuberculosis
following ritual circumcision. Arch Pediatr
1917; XXXIV:186-90.
- Gosden M. Tetanus following circumcision. Trans R
Soc Trop Med Hyg 1935; 28; 645-8.
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