Leave circumcision to us, surgeon tells GPs

THE NEW ZEALAND HERALD, 6 August 2002.

Leave it to us, surgeon tells GPs

06.08.2002 - By MARTIN JOHNSTON

An Auckland surgeon wants inadequately trained GPs to stop doing circumcisions because too many operations are being done badly.

Paediatric surgeon Stuart Ferguson says GP operations have left boys with infected and deformed-looking penises.

At Starship children's hospital in Auckland, surgeons repair at least 12 foreskins a year after doctors in the community have made mistakes.

And Mr Ferguson says that might be a fraction of the mismanaged cases.

The Royal New Zealand College of General Practitioners is trying to find the GPs responsible and plans to write guidelines and find training for doctors who want to perform circumcisions.

Mr Ferguson said some of the boys' penises were left looking "cosmetically unacceptable".

"A number have infections and a number have significant haemorrhage."

Some had too much skin removed, which might reduce sensation long-term.

The main problem was with boys who had received a "dorsal slit" operation in which the foreskin is cut lengthways but not removed, uncovering the head of the penis.

"It looks like Mickey Mouse with two big ears. I get a number of these and have to repair them when they are older," Mr Ferguson said.

An estimated 6 per cent of males are circumcised.

The Government pays only for circumcisions needed for medical reasons, such as a foreskin that is too tight or is frequently infected.

People wanting one for religious or cultural reasons must pay about $1000 for a surgeon to perform it at a private hospital.

GPs, who charge up to $300, are allowed to perform circumcisions.

But Mr Ferguson said they should do so only after significantly more surgical training than was now given to junior doctors.

A GP at Auckland's CityMed Medical Centre, Dr Gerald Young, said GPs could perform the operation safely if they were well-trained and had good facilities.

A spokesman for the Royal Australasian College of Surgeons, John Simpson, said circumcision should generally be left to specialist surgeons.

GPs' clinics mostly lacked the appropriate facilities.

Mr Simpson, a Wellington surgeon, said he had repaired faulty circumcisions on several Pacific Island boys aged 4 to 7.

They had suffered pain and infection for several weeks.

Citation:

Martin Johnston. Leave it to us, surgeon tells GPs. The New Zealand Herald, 6 August 2002.

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