Journal articles on the topic 'Circumcision'
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1
Sagir, Suleyman. "IMPACT OF CIRCUMCISION EXPERIENCES ON SURGICAL ANXIETY IN ADULTHOOD: A COMPREHENSIVE STUDY." Международный журнал научной педиатрии 2, no. 7 (July 31, 2023): 253–59. http://dx.doi.org/10.56121/2181-2926-2023-2-7-253-259.
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Objective: Our purpose was to investigate whether patients who had previously undergone circumcision (considering the timing and method of the procedure) experienced altered levels of anxiety when facing other surgeries later in life.
Materials and methods: It was investigated to what extent circumcision affects surgical anxiety. Patients who applied to our clinic to undergo surgery due to any disease in adulthood were included. The surgery anxiety scale was used for collection of the data. Results: This study involved 54 men, with an average age of 46.7 years, assessing their surgical anxiety scores in relation to various factors. While 59.3% had one surgery, significant minorities underwent multiple procedures. Regarding anesthesia during surgeries, 61.1% received local, 24.1% spinal, and 14.8% general anesthesia. Notably, 63% of participants were smokers. Previous hospitalization was reported by 51.9%, and 37% had other surgeries. Interestingly, 59.3% had contracted COVID-19. Age of circumcision showed no significant effect on anxiety scores. However, those who underwent forced circumcision (11.1%) had notably higher anxiety scores (p=0.04). Most circumcisions (96.3%) occurred in hospitals, with doctors conducting 81.48% of them. No correlation was found between patients' age during circumcision and current anxiety. Significantly, forced circumcisions led to increased surgical anxiety. Conclusions: Our study suggests that while circumcision's method, location, and performer significantly influence the individual's surgical anxiety in adulthood, the age of circumcision does not play a determining role.
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Gutwein, Luke G., Juan F. Alvarez, Jenny L. Gutwein, David W. Kays, and Saleem Islam. "Allocation of Healthcare Dollars: Analysis of Nonneonatal Circumcisions in Florida." American Surgeon 79, no. 9 (September 2013): 865–69. http://dx.doi.org/10.1177/000313481307900916.
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Circumcision remains a controversial operation. Most procedures are performed in the neonatal period and avoid general anesthesia. Legislation driven by policy statements from the American Academy of Pediatrics led to significant changes in circumcisions in Florida with a shift to non-neonatal procedures as a result of costs. We sought to study the prevalence and financial implications of nonneonatal circumcisions in Florida. A retrospective population study was performed using the Florida Agency for Health Care Administration outpatient procedure database. We queried for patients 0 to 17 years of age undergoing circumcision between 2003 and 2008. Demographics, charges, and insurance status were analyzed. From 2003 to 2008, 31,741 outpatient circumcisions were performed. Publicly funded circumcisions accounted for 17,537 charging the state $6,263 on average for each circumcision at an expense of $111.8 million for the 5-year time period analyzed. Publicly funded circumcision procedures increased more than sixfold ( P < 0.0001) than those covered by private insurance. Black circumcision procedures increased 77.3 per cent, whereas white circumcisions increased 28.7 per cent. There has been a significant increase in the number of nonneonatal circumcisions performed. This has resulted in an increase in economic health care. Public funding of neonatal circumcision could result in significant cost savings and avoid potential complications of general anesthesia.
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Anwer, Abdul Wahid, Lubna Samad, Sundus Iftikhar, and Naila Baig-Ansari. "Reported Male Circumcision Practices in a Muslim-Majority Setting." BioMed Research International 2017 (2017): 1–8. http://dx.doi.org/10.1155/2017/4957348.
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Introduction. Male circumcision is a recommended practice in Muslim tradition. It is important to ensure that this procedure is performed as safely as possible in these communities.Methods. Five hundred adult men and women with at least one male child less than 18 years were interviewed in Karachi, Pakistan, regarding details of their child’s circumcision. The survey focused on actual and perceived delays in circumcision and perceptions about appropriate age and reasons and benefits and complications of the procedure. Circumcisions done after two months of age were defined as delayed.Results. Religious requirement was the primary reason for circumcision in 92.6% of children. However, 89.6% of respondents were of the opinion that circumcision had medical benefits as well. Half of the children (54.1%) had delayed circumcision (range 2.5 months to 13 years), even though 81.2% of parents were of the opinion that circumcisions should be done within 60 days of birth. Facility-delivered babies had less delay in circumcisions (49.1%) as compared to home-delivered babies (60.5%).Conclusion. Understanding the perceptions and practices around male circumcision can help guide national strategies for designing and implementing safe circumcision programs in Muslim-majority settings, with the potential to benefit an annual birth cohort of 20–25 million boys worldwide.
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Hariyadi, Riski, Kholil Syu'aib, and Mustiah RH. "Denda Adat Mengkhitan Anak Perspektif Hukum Islam (Studi di Desa Rambah Kecamatan Tanah Tumbuh Kabupaten Bungo)." NALAR FIQH: Jurnal Hukum Islam 1, no. 1 (June 30, 2022): 13–29. http://dx.doi.org/10.30631/nf.v1i1.1273.
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This study aims to find out specifically the phenomenon of customary fines for children circumcising in Rambah Village, Tanah Tumbuh District, Bungo Regency and review the perspective of Islamic law on this phenomenon. This research is library research and field research, data collection method using interview, observation, and documentation. Data analysis went through three stages, namely data reduction, data presentation, conclusion drawing and verification. This study found that the customary fine practice of circumcising children in Rambah Village occurred because in the process of children circumcising it was considered to have violated twenty laws. Therefore, children circumcision in Rambah Village is subject to sanctions in the form of paying customary fines, the fines are in accordance with applicable customs. In Islam, circumcision is a matter of fitrah, whether male circumcision or female circumcision, there is no argument regarding fines when children circumcising. However, holding walimah circumcision in any form, it is permissible.
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Hariyadi, Riski, Kholil Syu'aib, and Mustiah RH. "Denda Adat Mengkhitan Anak Perspektif Hukum Islam (Studi di Desa Rambah Kecamatan Tanah Tumbuh Kabupaten Bungo)." NALAR FIQH: Jurnal Hukum Islam 13, no. 1 (June 30, 2022): 13–29. http://dx.doi.org/10.30631/nf.v13i1.1273.
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This study aims to find out specifically the phenomenon of customary fines for children circumcising in Rambah Village, Tanah Tumbuh District, Bungo Regency and review the perspective of Islamic law on this phenomenon. This research is library research and field research, data collection method using interview, observation, and documentation. Data analysis went through three stages, namely data reduction, data presentation, conclusion drawing and verification. This study found that the customary fine practice of circumcising children in Rambah Village occurred because in the process of children circumcising it was considered to have violated twenty laws. Therefore, children circumcision in Rambah Village is subject to sanctions in the form of paying customary fines, the fines are in accordance with applicable customs. In Islam, circumcision is a matter of fitrah, whether male circumcision or female circumcision, there is no argument regarding fines when children circumcising. However, holding walimah circumcision in any form, it is permissible.
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Safitri, Nimas Dwi, and Nur Maghfirah Aesthetika. "MAKNA KHITAN PEREMPUAN DALAM FILM PERTARUHANSEGMEN “UNTUK APA”." KANAL: Jurnal Ilmu Komunikasi 2, no. 2 (October 1, 2016): 169. http://dx.doi.org/10.21070/kanal.v2i2.297.
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Feminism is one of issues which always talked about. It is a reason for a young director like Nia Dinata in Kalyana Shira Films Production House makes some documenter films about woman (feminism). One of them is Pertaruhan. In this film, there is 4 segmens, and in the second segmen has title “Untuk Apa?” raises about female circumcision. In this segmen there are many symbols and signs which has hidden meanings. Semiotic used to reveal that denotation sign of female circumcisionin this film is as an implementation of syari’ah Islam. Connotative sign in this film is female circumcisionas a tradition and culture in society. They believe that female circumcisionis one of legitimate terms for being a Moslem. Myths in this film is an animism culture in society, people’s belief that female circumcisionable to decrease number of cheating in marriage and able to give more satisfy to her partner when doing intimate relationship.
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Atkin, GK, C. Butler, J. Broadhurst, A. Khan, R. Nataraja, N. Madden, M. Haddad, and SA Clarke. "Ritual Circumcision: No Longer a Problem for Health Services in the British Isles." Annals of The Royal College of Surgeons of England 91, no. 8 (November 2009): 693–96. http://dx.doi.org/10.1308/003588409x12486167520957.
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INTRODUCTION Primary care trust (PCT) funding of a ritual circumcision service has recently been withdrawn from our unit, raising concerns that this may result in greater morbidity from community circumcision. The aims of this study were to document our circumcision practice before and after the withdrawal of PCT funding and to determine its effect on the morbidity from circumcision. In addition, we wanted to survey all paediatric surgical centres in the British Isles to ascertain how many still offer a ritual circumcision service. PATIENTS AND METHODS We retrospectively reviewed our circumcision practice for 1 year prior to the removal of UK Government funding, and then performed a prospective audit of our practice for the 12 months following funding withdrawal. An e-mail survey was also performed of all paediatric surgical units to determine the ritual circumcision service provision throughout the British Isles. RESULTS A total of 213 boys underwent circumcision during the 12 months prior to the withdrawal of funding, of which 106 cases (50%) were ritual circumcisions. After funding withdrawal, 99 boys underwent circumcision, of which 98 cases (99%) were for medical reasons. A similar number of boys were re-admitted after a hospital circumcision during the two review periods (5 versus 4 patients), whereas the number admitted following a community circumcision rose after funding withdrawal (6 versus 11 patients). Only a third of British paediatric surgical centres offer a ritual circumcision service, and a significant proportion of these were either providing the service without PCT funding, or were reconsidering their decision to continue. CONCLUSIONS PCT funding withdrawal for ritual circumcision had an impact on our unit's procedural case volume. This represented a cost saving to the trust, despite a higher rate of admissions for postoperative complications. There is an inequality in healthcare provision throughout the British Isles for ritual circumcision, and we feel it is vital to offer support and training to medical and non-medical practitioners who are being asked to perform a greater number of circumcisions in the community.
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Emeka, Chukwubuike Kevin. "Neonatal circumcision: profile of neonates with complications resulting from the use of plastibell." European Journal of Clinical and Experimental Medicine 19, no. 1 (2021): 46–51. http://dx.doi.org/10.15584/ejcem.2021.1.7.
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Introduction. Circumcision is one of the most performed surgical procedures in neonates. Aim. The aim of this study was to evaluate our experience with neonates who developed complications following the use of plastibell for circumcision. Material and methods. This was a retrospective study of male neonates who were managed for complications resulting from circumcision (performed with plastibell) over a 5-year period at the pediatric surgery unit of a teaching hospital in Enugu, Nigeria. Ethical approval was obtained from the ethics and research committee. Results. Out of the 1794 neonatal circumcisions (using plastibell) performed during the study period, 134 (7.5%) neonates had complications. Sixty percent (1074) of the circumcisions were performed in the teaching hospital while 40% were referred cases. The ages of the patients ranged from 7 to 27 days with a median of 10 days and their mean weight was 2.5 kilograms. Majority of the plastibell circumcisions that developed complications was performed by unregistered (auxiliary) nurses. Retained plastibell was the most common complication and its removal was the most performed procedure. No mortality was recorded. Conclusion. Complications following circumcision with plastibell vary widely. Retained plastibell was the most common in the present study. The most complications occurred when the circumcision was performed by auxiliary (unregistered) nurses.
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Christakis, Dimitri A., Eric Harvey, Danielle M. Zerr, Chris Feudtner, Jeffrey A. Wright, and Frederick A. Connell. "A Trade-off Analysis of Routine Newborn Circumcision." Pediatrics 105, Supplement_2 (January 1, 2000): 246–49. http://dx.doi.org/10.1542/peds.105.s2.246.
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Background. The risks associated with newborn circumcision have not been as extensively evaluated as the benefits. Objectives. The goals of this study were threefold: 1) to derive a population-based complication rate for newborn circumcision; 2) to calculate the number needed to harm for newborn circumcision based on this rate; and 3) to establish trade-offs based on our complication rates and published estimates of the benefits of circumcision including the prevention of urinary tract infections and penile cancer. Methods. Using the Comprehensive Hospital Abstract Reporting System for Washington State, we retrospectively examined routine newborn circumcisions performed over 9 years (1987–1996). We used International Classification of Diseases, Ninth Revision codes to identify both circumcisions and complications and limited our analyses to children without other surgical procedures performed during their initial birth hospitalization. Results. Of 354 297 male infants born during the study period, 130 475 (37%) were circumcised during their newborn stay. Overall 287 (.2%) of circumcised children and 33 (.01%) of uncircumcised children had complications potentially associated with circumcision coded as a discharge diagnosis. Based on our findings, a complication can be expected in 1 out every 476 circumcisions. Six urinary tract infections can be prevented for every complication endured and almost 2 complications can be expected for every case of penile cancer prevented. Conclusions. Circumcision remains a relatively safe procedure. However, for some parents, the risks we report may outweigh the potential benefits. This information may help parents seeking guidance to make an informed decision.
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Ofoha, Chimaobi G., Sankey J. Babangida, Lemech E. Nabasu, and Nuhu K. Dakum. "Indications and safety of plastibell circumcision in children." International Surgery Journal 5, no. 5 (April 21, 2018): 1598. http://dx.doi.org/10.18203/2349-2902.isj20181577.
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Background: Circumcision is the surgical excision of the prepuce. It is an ancient practice with roots in religion and cultural practices. Indications for circumcision include phimosis, paraphimosis, balanoposthitis, balanitis, Balanitis xerotica obliterans and trauma to the prepuce. Various methods of circumcision have been described; Flap method, Gomco, Smartklamp and Plastibell etc. The Plastibell works by the clamp principle. The aim of this study is to determine the indications and safety of circumcision using the Plastibell device.Methods: This was a prospective study carried out in two hospitals for a period of one year. The parents were counselled on the procedure. The children were assessed to identify conditions that might adversely affect the outcome. The age of the babies, indication, size of Plastibel and complications were recorded.Results: Two hundred and forty-five infants were enrolled into the study. The age range was seven to one hundred and sixty-eight days. Majority of the circumcision was done in the first thirty days of life (63.8%). Indication for circumcision was religion (n=245, 100%) in all cases. The range of the Plastibel size used was 1.1 to 1.5. Ten of the children had complications representing 4.1%. The commonest complication was retained Plastibel, constituting 50% of the overall complications followed by bleeding (30%).Conclusions: Religion was the indication for the circumcisions and most of the circumcisions were done in the neonatal period. The Plastibell method of circumcision is associated with minor remediable complications when performed by trained personal.
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Djunaedi, Djunaedi, Andi Nursinah, Anshar Rante, and Rahmat Pannyiwi. "Gebyar Khitan Toraja “Khitanan Massal dan Layanan Kesehatan Gratis”." Sahabat Sosial: Jurnal Pengabdian Masyarakat 1, no. 3 (June 26, 2023): 111–15. http://dx.doi.org/10.59585/sosisabdimas.v1i3.73.
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Circumcision (circumcision) in Indonesian is known as circumcision or supit, which is a guideline for Islamic law for both men and women. Not only adherents of the Islamic religion perform circumcision, Jews, Christians and other religions now also practice circumcision because it is proven to provide health benefits. Circumcision or circumcision is a surgical procedure to remove the foreskin / prepuce / scalp of the penis. The purpose and benefits of this Mass Circumcision PkM is to reduce the risk of infection and even reduce the risk of penile cancer. Mass circumcising of Muslim children who are about to reach puberty in the Toraja area, Fulfilling the Prophet's Sunnah, Socializing the importance of maintaining health and cleanliness, Growing concern for others. The method used is Mass Circumcision using the smartklamp method and tubes that don't need stitches and bandages, so that the child can immediately do his activities as usual. The Klamp circumcision method was chosen because it is more comfortable for the child and has minimal pain and the participant/patient is circumcised without any complications from the circumcision procedure. It is hoped that the Circumcision PkM activities will go well according to the expectations of the community.
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Kojima, Noah, Claire C. Bristow, Neil Pollock, Pierre Crouse, Harry Theodore, Jerry Bonhomme, Claire F. Stéphanie Gaston, Jessy G. Dévieux, Jean William Pape, and Jeffrey D. Klausner. "Rapid Training and Implementation of the Pollock Technique, a Safe, Effective Newborn Circumcision Procedure, in a Low-Resource Setting." Global Pediatric Health 2 (January 1, 2015): 2333794X1558911. http://dx.doi.org/10.1177/2333794x15589114.
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Male circumcision is highly protective against urinary tract infections, inflammatory conditions of the penis, sexually transmitted infections, and urogenital cancers. We aimed to reintroduce newborn male circumcision through the creation of a training program in Port-au-Prince, Haiti—an area with a considerable burden of preventable urogenital infections, sexually transmitted infections, and low circumcision rate—after an earlier study reported that a majority of Haitian medical providers were in need of and wanted newborn circumcision training. The program was conducted at the GHESKIO Health Centers, a large, non-governmental clinic offering comprehensive pediatric and adult health services. Two Haitian obstetricians and seven nurses learned circumcision procedures. On training completion, one of two obstetricians achieved surgical competence. Introduction of a newborn male circumcision training program was feasible, achieving an acceptable rate of procedural competency and high-quality services. Permanent resources now exist in Haiti to train additional providers to perform newborn male circumcisions.
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Wiswell, Thomas E. "Letter to the Editor." Pediatrics 94, no. 3 (September 1, 1994): 407–8. http://dx.doi.org/10.1542/peds.94.3.407b.
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Doctors Anderson and Schwarz have misinterpreted the data from our recent report.1 We found an increasing number of circumcisions among older boys precisely at the time the circumcision frequency rate was increasing among neonates. We suspect the increases in both populations was due to several factors—the 1989 Ad Hoc Statement on Circumcision and the general increased awareness of the potential health benefits of the procedure. I am astounded that these physicians have stated there are no other countries in the western world with a rise in the rate of neonatal circumcision.
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Gudugbe, Senyo, Emmanuel Papa Kwadwo Acquah, Rosaline Seyram Akuaku, Brian Nuo-Ire Nang-Beifubah, Solomon Jaaga, and Patrick Maison. "Teasing-Induced Self-Circumcision in a Teenager: A Case Report." Journal of Advances in Medicine and Medical Research 35, no. 24 (December 22, 2023): 147–51. http://dx.doi.org/10.9734/jammr/2023/v35i245331.
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Aim: Male circumcision in traditionally circumcising communities is often performed by an experienced traditionalist or a surgeon. Transitioning through teenage years as an uncircumcised male in these communities can be challenging. This report highlights the psychosocial pressures of uncircumcised teenagers and the need for early formal circumcision to prevent self-injurious behaviour.
Case Presentation: We present a 13-year-old male, who performed a self-circumcision using a kitchen knife after enduring repeated teasing episodes at annual sports camps. He was resuscitated and later had penile skin reconstruction done. He did not have an underlying psychological disorder.
Discussion: Self-circumcision is rare and mostly reported amongst patients with underlying psychological disorders. Cases amongst teenagers with no underlying pathologies are ever rarer. Negative peer pressure in the form of teasing and push such patients to self-injurious behaviour. Early appropriate surgical intervention following self-circumcision results in good clinical outcomes.
Conclusion: Uncircumcised teenagers in traditionally circumcising communities may suffer adverse psychological trauma from peers leading to self-harm. Parents of such children should seek early medical care to avert the risks of self-injurious behaviour.
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Ryan, C. Anthony, and Neil N. Finer. "Changing Attitudes and Practices Regarding Local Analgesia for Newborn Circumcision." Pediatrics 94, no. 2 (August 1, 1994): 230–33. http://dx.doi.org/10.1542/peds.94.2.230.
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Study objective. To change physician attitudes and practices regarding the routine use of local and regional anesthesia for newborn circumcision. Design. Interventional study, followed by an audit of physician practice over a 1-month period, 1 year following interventions. Setting. The newborn nurseries of the Womens' Pavilion, Royal Alexandra Hospital, Edmonton. Interventions. A broad range of awareness and educational programs were directed at physicians who perform newborn circumcisions, including posters, newsletters, presentations at grand rounds, video recordings, and practical "hands-on" demonstration of the techniques of local anesthesia to the prepuce and dorsal penile nerve block. Results. Only one physician was using local analgesia for newborn circumcision prior to the introduction of the educational program. The audit, performed 12 months later, documented 46 circumcisions performed by 22 physicians, each performing between 1 and 6 circumcisions (median = 1). Sixteen of the 22 physicians (73%) used either local anesthesia to the prepuce (19 cases) or dorsal penile nerve block (13 cases) during circumcisions. Thus, local analgesia was used in 66% (32/48) of all circumcisions. Six physicians, performing 16 circumcisions, did not use any form of analgesia. Conclusions. This simple educational program has been associated with a remarkable change in attitudes and practice regarding local analgesia for neonatal circumcision. Our ideal objective, which we hope to achieve through repeated education and practical demonstrations of the techniques to interested physicians, is that all newborn circumcisions are performed under local or regional anesthesia in our institution.
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Kogan, Claudio J. "Commentary on "Circumcision"." Narrative Inquiry in Bioethics 13, no. 2 (June 2023): 113–28. http://dx.doi.org/10.1353/nib.2023.a909672.
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Abstract: This commentary draws upon the author's experience in bioethics and as a physician, ordained Rabbi, and certified Mohel (a Jewish professional qualified to perform infant male circumcisions (MC)). People's identity and adherence to a religious belief are frequently cited reasons for deciding whether to circumcise their male children. For Jewish and Muslim males, circumcision is considered essential. In this commentary, the author uses his medical, religious, and bioethical knowledge, expertise, and experience to address common arguments used in opposing nontherapeutic male circumcision of minors. In these narratives, half of the parents agreed with circumcision, and half did not. The parents against circumcision cite human rights violations, security, privacy, and bodily integrity issues and refer to circumcision as genital mutilation, while those who agree argue that circumcision should be done for religious reasons to prevent health issues, promote hygiene and cleanness, avoid cancer, or for later sexual enjoyment. After evaluating the evidence, the author states that parents should be free to either consent or decline MC for a son. Though a reoccurring theme in these narratives was for mothers to leave the circumcision decision up to their male partners, the author concludes that women have considerable power regarding the decision.
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Nabavizadeh, Behnam, Kevin D. Li, Nizar Hakam, Nathan M. Shaw, Michael S. Leapman, and Benjamin N. Breyer. "Incidence of circumcision among insured adults in the United States." PLOS ONE 17, no. 10 (October 17, 2022): e0275207. http://dx.doi.org/10.1371/journal.pone.0275207.
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Purpose Although circumcision is the most commonly performed surgery in males, less is known about the incidence and indications of adult circumcision. In this study, we aim to present the incidence of adult circumcision across the United States. Methods Using IBM MarketScan® Commercial Database from 2015 to 2018, we obtained claims for circumcision in men between 18 and 64 years of age. We calculated the incidence of adult circumcision over the study period and across the United States. We also collected data on indications for surgery using International Classification of Diseases codes. Results We identified a total of 12,298 claims for adult circumcisions. The mean age was 39 (±12.9) years. The average incidence rates remained relatively constant from 98.1 per 100,000 person-years in 2015 to 98.2 per 100,000 person-years in 2018 (Δ+0.1%). The age-standardized incidence rates varied significantly across the United States (from 0 to 194.8 per 100,000 person-years) with South Dakota having the highest rate. The most common indications for adult circumcision were phimosis (52.5%), routine/ritual circumcision (28.7%), phimosis + balanitis/balanoposthitis (6.8%), balanitis (3.8%) and balanoposthitis (2.6%), and significantly varied by age groups. Conclusion This study suggested a wide geographic variation in rates of adult circumcision between states with highest incidences in the Northeast United States. Future studies can identify the underlying causes for the observed variations.
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Bawazir, Osama Abdullah, and Hatem Sembawa. "Male Circumcision: A Practice Survey from Saudi Arabia." Journal of King Abdulaziz University - Medical Sciences 26, no. 2 (December 31, 2019): 45–51. http://dx.doi.org/10.4197/med.26-2.5.
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The study aims to evaluate the various techniques used to perform circumcision in Saudi Arabia. In September 2018, this cross-sectional survey was performed. A questionnaire was sent to all pediatric surgery units across the Kingdom. The responses to the questionnaire were analyzed and categorized. A total of 176 questionnaires were send and more than half (56.3%) of the practitioners filled the questioners, 62 (63%) were consultants, 19 (19%) were specialists and 19 (19%) were trainee in pediatric surgery fellowship program. Circumcisions were performed in Maternity and Children hospitals (32.3%), tertiary hospitals (32.3%), private hospitals (16%) and in general or academic hospitals (19%). The most commonly used method for circumcision was Gomco clamp (n = 39; 39.6%) followed by Plastibell (n = 30; 30%) and bone cutter (n = 25; 25.4%). The optimal time for circumcision was in neonatal period. Eighty-six percent of the surgeons agree that 2.5 to 5 kg is the optimal weight for the baby to do circumcision. In Saudi Arabia circumcision is a religious practice done for every Muslim male. It should be done by trained medical practitioner and circumcision done by non-medical personal should be avoided. Circumcision should be performed in the neonatal period and attention should be given to analgesia.
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Derry Trisna Wahyuni S, Alif Rahman Habibi, Hardiyanti, Hartati, and Nurul Qomariah. "Penyuluhan Manfaat Khitanan Bagi Kesehatan Dan Khitanan Massal Dilaksanakan Di Akademi Kesehatan Kartini Batam." JURNAL AKADEMIK PENGABDIAN MASYARAKAT 2, no. 3 (May 15, 2024): 15–18. http://dx.doi.org/10.61722/japm.v2i3.1305.
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The process of removing the skin covering the tip of the penis is known as circumcision. The law of circumcision for boys in Islam is mandatory. The goal is not only to obey religious orders, but also to prevent feces from sticking to the penis, making urination easier, and reducing the pleasure of intercourse. Apart from that, there are many benefits of circumcision after doing it, but there are still children who don't know what circumcision is and its benefits based on data analysis. The community will be given free circumcisions to carry out one of the Tridharma activities of higher education which is being carried out in Batam City. At this stage, the children were circumcised by doctors from Budi Kemuliaan Hospital, assisted by lecturers from the Kartina Batam Health Academy and lecturers from the Putra Jaya Health Analytical Academy, Batam. After the circumcision process, it is checked again after 3 days. Through the implementation of Community Service in 2024, the target of this activity is to provide education to the public to avoid various kinds of genital diseases, so that public health can be more guaranteed. Circumcision not only functions to clean vital human organs, but circumcision has many health benefits, including AIDS, penile cancer, prostate cancer and urinary tract infections.
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Anderson, Peter A., and Robert D. Schwarz. "Circumcision Questions." Pediatrics 94, no. 3 (September 1, 1994): 407. http://dx.doi.org/10.1542/peds.94.3.407.
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The article by Wiswell et al (Pediatrics 1993;92:791-793) on the circumcision rate of boys beyond the neonatal period reports findings that we do not find surprising: if less circumcisions are done on neonates, more will be done at a later age. One would presume that a similar study on the tonsifiectomy rate would show that because young children no longer undergo routine removal of this organ, the operation is now more commonly done in older children.
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Choudhry, Zafar Ali. "Circumcision; A Comparative Study Between ZACH Self-Locking Clamp & Bone Cutter." Annals of Punjab Medical College 15, no. 1 (March 31, 2021): 6–8. http://dx.doi.org/10.29054/apmc/2021.1104.
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Background: The circumcision has been performed for religious, ethnic and medical response. In Pakistan 85%-90% of circumcisions are performed by traditional circumcisers. The surgical technique for circumcision involves traditional bone cutter. Objective: To compare the results of one of the most commonly performed surgical procedure, circumcision, by bone cutter and ZACH self-locking circumcision clamp method in terms of complications such as trauma to glans, bleeding and infection along with cosmetic outcome. Study Design: Randomized control trial. Settings: Department of Surgery in Allied Hospital, Faisalabad Pakistan. Duration: September 2018 to November 2019. Methodology: Total 160 patients were selected from OPD on the basis of non-probability consecutive sampling. After careful history taking and physical examination, patients fulfilling the criteria were identified into two equal groups, one underwent circumcision with Bone Cutter and the other with Zach self-locking circumcision clamp. Parents were instructed to follow up in the surgical OPD after seven days for assessment and earlier in case of any complication. Results: There was significant difference in terms of bleeding, superficial infection, cosmetic appearance and trauma to glans (P-value > 0.05). Conclusion: Zach self-locking clamp proved to be safe and effective technique with reproducible results as compared to bone cutter.
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Torosian, Taron, Joshua J. Quint, and Jeffrey D. Klausner. "Decline in Frequency of Newborn Male Circumcision After Change in Medicaid Coverage Status in Selected States in the United States." Public Health Reports 136, no. 3 (January 13, 2021): 338–44. http://dx.doi.org/10.1177/0033354920971719.
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Objectives Male circumcision is linked to a reduction in the risk of HIV infection, sexually transmitted infections, penile inflammatory skin disorders, cancers, urinary tract infections, and other complications. We examined the extent to which the change in circumcision recommendation by the American Academy of Pediatrics in 1999 and Medicaid coverage status in states affected the total number of procedures performed. Methods We used data from the Nationwide Inpatient Sample for 1998-2011 collected annually by the Healthcare Cost and Utilization Project. We examined data on all male births in the United States with Medicaid and private health insurance. We then categorized births into 4 groups: (1) births with newborn male circumcision procedure, (2) births with Medicaid or private health insurance, (3) births that occurred in states where Medicaid coverage for newborn male circumcision was removed, and (4) births that occurred before or after the policy change. We used multivariable logistic regression to estimate the adjusted odds of newborn male circumcision. Results In the 10 states where a change in Medicaid policy occurred, circumcision frequency had a mean percentage-point decrease of 21.4% among Medicaid beneficiaries and 3.2% among private health insurance beneficiaries from before to after the policy change. In states where coverage was maintained, the change in circumcision frequency was negligible for Medicaid and private health insurance beneficiaries. These changes resulted in an estimated 163 456 potential circumcisions not performed. Conclusion Decreases in newborn male circumcision frequency correlated with the Medicaid policy change for the procedure. Efforts should be made to reduce barriers for cost-effective preventive procedures that promote health, such as newborn male circumcision.
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Maddileti, Varunkumar, Suhasini Gazula, and Praveena Dantala. "Primary care of preputial adhesions in children – a retrospective cohort study." Malaysian Family Physician 17, no. 1 (March 15, 2022): 52–56. http://dx.doi.org/10.51866/oa.27.
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Introduction: Aside from religious circumcisions, the indications for circumcision are few. However, in the cultural context, many patients are unnecessarily referred for circumcision for physiological phimosis (adhesions). Due to parental concerns and misperceptions by general practitioners, nonretractile prepuce is one of the most common indications for referral to a paediatric surgeon in many countries. This study aimed to determine whether preputial adhesiolysis successfully managed symptomatic non-retractile foreskin and therefore prevented the need for circumcision. Methods: A retrospective review was performed of the health records of children who presented with preputial adhesion. We included 65 symptomatic patients (ballooning of the prepuce in all cases and additional dysuria in three cases) who underwent preputial adhesiolysis. All cases were followed up for 2 years. Circumcision was subsequently carried out for patients who developed fibrous scarring resulting in difficult retraction due to the development of thick adhesions or skin fissuring with persistence of symptoms. Results: Of the 65 boys, 58 (89.2%) achieved complete retraction of the prepuce. The remaining 7 boys (10.8%) presented with recurring symptoms and thick fibrosed prepuce, and they underwent circumcision due to the dense adhesions. Histopathological examination of the circumcised prepuces revealed balanitis xerotica obliterans in two cases. Conclusion: Preputial adhesiolysis is a safe and effective treatment for symptomatic preputial adhesions in boys younger than 5 years old. The procedure avoids circumcision and its associated risks. Preputial adhesiolysis should be offered as a primary treatment instead of circumcision.
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Aydoğdu, Bahattin, Mustafa Azizoğlu, and Mehmet Hanifi Okur. "Social and psychological effects of circumcision: A narrative review." Journal of Applied Nursing and Health 4, no. 2 (December 30, 2022): 264–71. http://dx.doi.org/10.55018/janh.v4i2.110.
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Descriptions of penile circumcision have focused primarily on disease, dysfunction, or sensation, with relatively little consideration of the psychological and psychosocial implications of the procedure. It is also reported to be of interest regarding potential qualitative changes in the subjective experience of sexual activity following changes in penile anatomy (removal of the foreskin) or related sexual biomechanics. Circumcision indeed has psychological, psychosocial, and psychosexual effects. The differences in circumcisions performed during infancy, childhood, and adulthood are remarkable. There are also potential psychosocial effects on parents who may or may not choose circumcision for their children. We argue that additional attention should be paid to the potential for long-term effects of the procedure, which may not be appropriately considered when the patient is an infant or child.
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Loban, Akhter Hossain, and Md Shahidul Islam. "Safe Circumcision Anaesthesia A Review." Journal of the Bangladesh Society of Anaesthesiologists 26, no. 1 (August 3, 2014): 52–53. http://dx.doi.org/10.3329/jbsa.v26i1.19817.
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Circumcision of Neonate, Infant, Children as well as adult is done for many purposes of them religious, disease process and to prevent some diseases. Pain is the main problem of circumcision. Infant and Children will not allow local analgesia. General anaesthesia needed for them. Neonate and adult may allow local anaesthesia. So, local anaesthesia, general anaesthesia, combination of local and general anaesthesia can be given. It is a minor procedure but anaesthesia for circumcision is not easy and should not be taken lightly. Complications related to circumcision anaesthesia can be minimized by proper selection of patient and type of anaesthesia. In our country circumcision done for religious purpose so a large number of circumcisions done by professional hazzam (non doctor). Doctors including general practitioners and surgeons are also doing this procedure. Complications related to anaesthesia are mainly laryngospasm and hypoxia and ultimately cardiac and cerebral complications. Some of them are highlighted in the media and newspapers but unknown cases are not less. If we can prevent and manage the complications like laryngospasm then this procedure can be done safely. DOI: http://dx.doi.org/10.3329/jbsa.v26i1.19817 Journal of Bangladesh Society of Anaesthesiologists 2013; 26(1): 52-53
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Widjajanto, Pudjo Hagung, Ridwan Tjandra Sugiarto, Sutaryo Sutaryo, and Kaiser Ali. "Circumcision in boys with mild Hemophilia A – the Yogyakarta experience." Paediatrica Indonesiana 47, no. 2 (May 1, 2007): 71. http://dx.doi.org/10.14238/pi47.2.2007.71-3.
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Background In boys with hemophilia, there is a risk ofhemorrhage resulting from circumcision. There has been nostandardised management in Indonesia. We report our experiencewith 4 hemophiliac boys who underwent circumcision at Dr.Sardjito General Hospital, Yogyakarta, in south-central Java.Objective To develop a safe, practical and accessible method toprevent bleeding in boys with hemophilia undergoing circumcisionin Indonesia.Methods Written informed consent was obtained from parentsrequesting the procedure. All boys had mild Hemophilia A (VIII:C level >7.8 U/ml) diagnosed at a median age of 4.4 years (range0.75–9 years). Median age at time of circumcision was 7.5 years(range 0.8–12 years).Results There were no intraoperative or post-circumcisionbleeding problem encountered in any of the patients, who weredischarged from hospital three days post-surgery. On follow upeight days and 12 days post-circumcision, they remained free ofcomplications.Conclusion Circumcision can be safely performed in boys withmild Hemophilia A following adequate pre-operative planningand prophylactic therapy. A standardised protocol for theYogyakarta Bleeding Disorders Program. evolving from thisexperience, is being planned.
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Ravindraanandan, Manoj, Herman Fernando, and Shahjahan Aslam. "Continuous suturing as a wound closure technique for circumcisions." Journal of Clinical Urology 12, no. 6 (May 22, 2019): 470–73. http://dx.doi.org/10.1177/2051415819849319.
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Male circumcision is an extremely common urological procedure worldwide, with many variations in technique. Despite the large volume there is a low incidence of complications associated with circumcisions, with the majority being Clavien-Dindo I or II. In this study, we analyse the outcomes and complication rates associated with a continuous wound closure following a male circumcision. Methods: In a urology department from a single institution, 201 male circumcisions with a continuous wound closure were performed in a 4-year period. Outcomes were analysed retrospectively looking at postoperative complications and readmissions to hospital via our clinical portal. Results: No patients had complications that required admission or re-operation at our institution. Conclusion: No major post-operative complications were observed from our cohort. There were also no documented admissions back to our institution with wound healing complications. However, a limitation is that Clavien-Dindo I and II complications and treatment at general practitioner surgeries were not captured and may not accurately represent our complication rates quoted. Nevertheless, we can conclude from these data that closure for a circumcision using a continuous suture technique gives favourable outcomes with acceptable complication rates. Level of evidence: Not applicable for this multicentre audit.
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DeMaria, J., A. Abdulla, J. Pemberton, A. Raees, and L. H. Braga. "Are Physicians Performing Neonatal Circumcisions Well Trained?" Canadian Urological Association Journal 7, no. 7-8 (August 19, 2013): 260. http://dx.doi.org/10.5489/cuaj.200.
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Introduction: Notwithstanding the recommendations from the Canadian Pediatric Association and the American Academy of Pediatrics on the indications for neonatal circumcision, this procedure is still common in North America and throughout the world. Our purpose is not to argue whether this procedure should be done, but rather to examine who is doing it, their training, how it is performed and how can we prevent unsatisfactory results and complications. The objective is to identify what fields of knowledge require improvement and then design a teaching module to improve the outcomes of neonatal circumcision.Methods: A 19-question cross-sectional survey, including a visual identification item, was submitted to 87 physicians who perform neonatal circumcisions in Southwestern Ontario, Canada. To improve our response rate, study subjects were contacted in a variety of ways, including mail and fax and telephone. Once the survey was completed, we produced a surgical technique training video on using the Gomco clamp and the Plastibell techiques. A knowledge dissemination workshop was held with survey participants to discuss contraindications and the use of anesthesia and management of complications of neonatal circumcision and to evaluate the surgical technique training video. A 6-month followup questionnaire was completed to determine the impact of the teaching course on participants’ daily practice.Results: In total, we received 54 responses (62% response rate). From these, 46 (85%) were family doctors and pediatricians, while the remaining 8 (15%) were pediatric general surgeons and urologists. The circumcisions were carried out with the Gomco clamp 35 (63%) and the Plastibell 21 (37%). No respondent admitted to learning the procedure through a structured training course. Of the non-surgeons, 19 (43%) learned to perform a circumcision from a non-surgeon colleague. A little over a third of the participants (17, 31%) were happy to perform a circumcision in a child born with a concealed penis, where circumcision is contraindicated. With respect to the early complications post-circumcision, 8 (100%) surgeons versus 29 (63%) non-surgeons felt comfortable dealing with bleeding (p = 0.046). In total, 7 (88%) surgeons versus 16 (35%) non-surgeons were comfortable dealing with urinary retention (p = 0.01). Also, 8 (100%) surgeons versus 24 (52%) non-surgeons were comfortable dealing with a wound dehiscence (p = 0.02). Moreover, 6 (75%) surgeons and 5 (10%) non-surgeons were comfortable managing meatal stenosis (p < 0.01). Five (63%) surgeons versus 15 (33%) non-surgeons were confident in dealing with a trapped penis post-circumcision (p = 0.24).Conclusions: Our survey findings indicate that most physicians performing neonatal circumcisions in our community have received informal and unstructured training. This lack of formal instruction may explain the complications and unsatisfactory results witnessed in our pediatric urology practice. Many practitioners are not aware of the contraindications to neonatal circumcision and most non-surgeons perform the procedure without being able to handle common post-surgical complications. Based on our survey findings, we planned and carried out a formal training course to address these issues.
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Earp, Brian D., Veerajalandhar Allareddy, Veerasathpurush Allareddy, and Alexandre T. Rotta. "Factors Associated With Early Deaths Following Neonatal Male Circumcision in the United States, 2001 to 2010." Clinical Pediatrics 57, no. 13 (August 1, 2018): 1532–40. http://dx.doi.org/10.1177/0009922818790060.
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We sought to quantify early deaths following neonatal circumcision (same hospital admission) and to identify factors associated with such mortality. We performed a retrospective analysis of all infants who underwent circumcision in an inpatient hospital setting during the first 30 days of life from 2001 to 2010 using the National Inpatient Sample. Over 10 years, 200 early deaths were recorded among 9 833 110 subjects (1 death per 49 166 circumcisions). Note: this figure should not be interpreted as causal but correlational as it may include both undercounting and overcounting of deaths attributable to circumcision. Compared with survivors, subjects who died following newborn circumcision were more likely to have associated comorbid conditions, such as cardiac disease (odds ratio [OR] = 697.8 [378.5-1286.6]; P < .001), coagulopathy (OR = 159.6 [95.6-266.2]; P < .001), fluid and electrolyte disorders (OR = 68.2 [49.1-94.6]; P < .001), or pulmonary circulatory disorders (OR = 169.5 [69.7-412.5]; P < .001). Recognizing these factors could inform clinical and parental decisions, potentially reducing associated risks.
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Gu, Chaohui, Fengyan Tian, Zhankui Jia, Guanru Li, Zhenglei Meng, Weizhi Xing, Yafei Ding, Zhibo Jin, Quancheng Kan, and Jinjian Yang. "Introducing the Quill™ Device for Modified Sleeve Circumcision with Subcutaneous Suture: A Retrospective Study of 70 Cases." Urologia Internationalis 94, no. 3 (2015): 255–61. http://dx.doi.org/10.1159/000368660.
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Objective: The purpose of the study was to evaluate the safety and feasibility of treatment for male circumcision using modified sleeve circumcision and subcuticular suture with the Quill™ device. Methods: From May 2011 to March 2012, 70 consecutive cases of male circumcision were performed using an alternative technique with the Quill™ device by a single surgeon in our institution. The inclusion and exclusion criteria for the selection process of this procedure were the same as for conventional circumcision. We evaluated the indications and perioperative outcomes. The circumcisions were performed as day-case procedures under local anesthesia. Results: All patients were followed up for a minimum of 3-6 months. The ages ranged from 8 to 68 (mean = 27.0 years, SD = 10). The indications for surgery were either cosmetic (n = 16, 22.9%) or medical [redundant prepuce (n = 36, 51.4%), phimosis (n = 5, 7.1%), paraphimosis (n = 2, 2.9%), balanoposthitis (n = 9, 12.9%), melanoma (n = 1, 1.4%), and condyloma acuminata (n = 1, 1.4%)] (n = 54, 77.1%). The mean operation time in this group was 29 min (19-38 min) when the Quill™ device was used. In all, 3 cases developed complications (4.3%). The final cosmetic result was satisfactory for both the patients and their spouses or parents. Conclusion: This study showed that modified sleeve circumcision and subcuticular suture were safe and reliable surgical methods of circumcision that provide a better cosmetic result.
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Gamidov, S. I., N. K. Druzhinina, T. V. Shatylko, N. G. Gasanov, R. I. Safiullin, and K. S. Guluzade. "Surgical correction of circumcision complications." Andrology and Genital Surgery 24, no. 4 (November 29, 2023): 144–54. http://dx.doi.org/10.17650/2070-9781-2023-24-4-144-154.
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Background. Circumcision is one of the most commonly performed surgical procedures in men. Approximately 20 % of men in the world have undergone circumcision. It helps to prevent infections and inflammatory diseases of the lower urinary tract and reduces the risk of sexually transmitted diseases, helps to reduce the risk of developing glans cancer in men and cervical dysplasia in women. Being aware of complications that may occur after circumcision allows to conduct the surgery in a way that minimizes the risk of complications.Aim. To analyze both the circumcisio complications and their surgical management.Materials and methods. A retrospective analysis of a case series of 53 patients with complications after circumcision was performed: 30 patients underwent circumcision in childhood (average age 3.2 ± 1.8 years), 23 patients have been circumcised as adults (average age 34.9 ± 7.8 years). Complications that occurred in different age groups were analyzed, as well as their surgical management.Results. In this study, complications such as insufficient foreskin excision, severe scarring of the penile skin, phimosis recurrence, excessive foreskin excision, residual synechiae on the glans, amputation of the glans or the shaft, bleeding or hematoma formation, purulent inflammatory disease of the penile skin and glans, complications caused by local anesthetics, urethral injury with subsequent fistula formation or ischemia, meatostenosis have been observed in patients. All patients underwent surgical correction to achieve high functional and cosmetic results.Conclusion. Understanding the causes of circumcision complications and surgical management is a high priority task for the andrology community.
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WISWELL, THOMAS E. "In Defense of Circumcision." Pediatrics 77, no. 2 (February 1, 1986): 266–67. http://dx.doi.org/10.1542/peds.77.2.266.
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In Reply.— Do neonatal circumcisions need infant consent? Obviously, no. Because neonates are minors, the burden is on the parents to make the necessary decision based on informed consent. The general belief in the past 10 to 15 years has been that there is no medical indication for routine performance of circumcision in the newborn. However, we recently published data demonstrating a decreased incidence of urinary tract infections during the first year of life in circumcised male infants.1
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Jaradeh, Katrin, Tyler Van Fleet Kingery, Jackline Cheruiyot, Francesca Odhiambo, Elizabeth A. Bukusi, Craig R. Cohen, and Starley B. Shade. "Cost comparison of a rapid results initiative against standard clinic-based model to scale-up voluntary medical male circumcision in Kenya." PLOS Global Public Health 3, no. 3 (March 29, 2023): e0000817. http://dx.doi.org/10.1371/journal.pgph.0000817.
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Voluntary male medical circumcision (VMMC) reduces HIV acquisition by up to 60%. Kenya has successfully scaled up VMMC to an estimated 91% of eligible men and boys in certain regions in combination due to VMMC and cultural circumcisions. VMMC as a program is implemented regionally in traditionally non-circumcising counties where the prevalence is still below 91%, ranging from 56.4% to 66.7%. Given that funding toward VMMC is expected to decline in the coming years, it is important to identify what models of service delivery are most appropriate and efficient to sustainably meet the VMMC needs of new cohorts’ eligible men. To this end, we compared the costs of facility-based VMMC and one within a rapid results initiative (RRI), a public health service scheduled during school holidays to perform many procedures over a short period. We employed activity-based micro-costing to estimate the costs, from the implementer perspective, of facility-based VMMC and RRI-based VMMC conducted between October 2017 and September 2018 at 41 sites in Kisumu County, Kenya supported by the Family AIDS care & Education Services (FACES). We conducted site visits and reviewed financial ledger and programmatic data to identify and quantify resources consumed and the number of VMMC procedures performed during routine care and RRIs. Ledger data were used to estimate fixed costs, recurring costs, and cost per circumcision (CPC) in United States dollar (USD). A sensitivity analysis was done to estimate CPC where we allocated 6 months of the ledger to facility-based and 6 months to RRI. Overall, FACES spent $3,092,891 toward VMMC services and performed 42,139 procedures during the funding year. This included $2,644,910 in stable programmatic costs, $139,786 procedure costs, and $308,195 for RRI-specific activities. Over the year, 49% (n = 20,625) of procedures were performed as part of routine care and 51% (n = 21,514) were performed during the RRIs. Procedures conducted during facility-based cost $99.35 per circumcision, those conducted during the RRIs cost $48.51 per circumcision, and according to our sensitivity analysis, CPC for facility-based ranges from $99.35 to $287.24 and for RRI costs ranged from $29.81 to $48.51. The cost of VMMC during the RRI was substantially lower than unit costs reported in previous costing studies. We conclude that circumcision campaigns, such as the RRI, offer an efficient and sustainable approach to VMMC.
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Wellington, Nancy, and Michael J. Rieder. "Attitudes and Practices Regarding Analgesia for Newborn Circumcision." Pediatrics 92, no. 4 (October 1, 1993): 541–43. http://dx.doi.org/10.1542/peds.92.4.541.
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Study objective. To determine attitudes regarding routine use of analgesia for newborn circumcision among primary care physicians in southwestern Ontario. Design. Questionnaire survey conducted among all family physicians and pediatricians belonging to the London Academy of Medicine. The majority of pediatric primary care in this region is provided by family physicians. Setting. Metropolitan center in Southwestern Ontario. Respondents. A questionnaire was mailed to 279 physicians; 171 (61%) responded. Results. Seventy-four (43%) respondents performed circumcisions. Among physicians performing circumcisions, a minority (17; 24%) used any form of analgesia. The most commonly used analgesic (14; 20%) was oral ethanol. Only 3 (4%) physicians used dorsal penile nerve block. The most common reasons listed for not employing analgesia were lack of familiarity with analgesia use among neonates (56%), lack of familiarity with the technique of dorsal penile block (50%), and concern over adverse effects of analgesic drugs (49%) and regional analgesia (44%). Only a small minority of physicians (7; 12%) responded that they believe that neonates do not feel pain, and 20 (35%) believe that neonates do not remember pain. Conclusions. Despite evidence that neonates perceive pain and that there is a physiologic stress response to circumcision which can be reduced if analgesia is employed, the vast majority of physicians performing newborn circumcisions either do not employ analgesics or employ analgesics of questionable efficacy. Lack of familiarity with the use of analgesics among neonates and with dorsal penile block in particular are the most common reasons cited for lack of analgesic use. Educational efforts and research into less invasive techniques of analgesia for newborn circumcision are urgently required.
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Barg, Assaf Arie, Sarina Levy Mendelovich, Shadan Lalezari, Shirley Azar Aviv, Dalia Bashari, and Gili Kenet. "Neonatal circumcision in patients with haemophilia is safe – a single centre experience." Journal of Haemophilia Practice 4, no. 1 (January 26, 2017): 32–34. http://dx.doi.org/10.17225/jhp00092.
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Abstract Consensus evidence-based guidelines regarding prophylactic treatment for circumcision in patients with haemophilia are lacking. In this study, we retrospectively examined the results of circumcision of 40 consecutive neonates with haemophilia, diagnosed after delivery. Our protocol included application of a single dose of factor replacement prior to the procedure and 3 days’ oral treatment with tranexamic acid. Only 3/40 neonates with haemophilia experienced mild postcircumcision bleeding. No major or any life-threatening bleeds were encountered. As the therapy administered was minimal and the procedure simple and feasible, we concluded that circumcision in neonates with haemophilia should be performed according to family’s and physician’s discretion. Avoidance of circumcising male babies with haemophilia due to fear of bleeding complications is not supported by the results shown within our patient cohort.
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Zamilpa, Ismael, Ashay Patel, Joshua Booth, and Stephen Canon. "To Finish the Cut or Not." Clinical Pediatrics 56, no. 2 (July 19, 2016): 157–61. http://dx.doi.org/10.1177/0009922816648287.
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We retrospectively evaluated the management of patients with unrecognized glanular hypospadias and a completed (group 1) or aborted (group 2) neonatal circumcision. The rate and type of subsequent surgeries performed were analyzed. Penile curvature, urinary stream deviation, and their impact on management were evaluated. Surgery was done in 55% of patients—40% of group 1 and 86% of group 2. Completion of the circumcision was done in 63% of group 2. Hypospadias repair was performed in 56% of group 1 and in 34% of group 2. Penile curvature rate did not affect the rate or type of surgery performed. Urinary stream deviation did not affect the rate of repair, but was a significant factor leading to hypospadias repair. We concluded that providers performing neonatal circumcisions do not have to abort the procedure when a glanular hypospadias is noticed. Most patients will require circumcision completion only.
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Halepota, Huma Faiz, Ahmad Vaqas Faruque, and Muhammad Arshad. "Circumcision in patients with bleeding disorders: Can it be done safely?" Journal of Bahria University Medical and Dental College 08, no. 02 (June 4, 2018): 109–13. http://dx.doi.org/10.51985/jbumdc2018003.
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Purpose: The purpose of our study was to review outcome of circumcision among children with bleeding disorders at our institution and also to determine the impact of optimization leading to safe circumcision. Methods: Data representing boys (age 0-16 years) who underwent routine circumcision at the Aga Khan University Hospital (AKUH) between1988-2014 was retrospectively reviewed. Children with bleeding disorder were identified using International Classification of Diseases (ICD) Code 64.0. Data was retrieved and confidentially was maintained. SPSS version 19 was used for statistical analysis. Results: During 26 years 13,200 circumcisions were performed at AKUH. Amongst these 8,463 (64.11%) were done by using Plastibell, while 4,737 (35.88%) by open slit method. Only 23 (0.17%) children were identified with bleeding disorder. Two groups were made, Group-A (n:15) children with known bleeding disorders having circumcision and GroupB, (n:8) those in whom bleeding disorder was diagnosed after circumcision. Median age of children in Group-A was 9 years. All children in Group-A underwent open circumcision. 10 patients had Factor VIII deficiency, 2 had Glanzmann’s thrombasthenia, 1 had Factor IX deficiency, 1 had Quebec platelet disorder, and 1 had Von Willebrand disorder. Median age of children in Group-B was 3 months. 7 out of 8 underwent plastibell while one had circumcision by open technique. 7 were diagnosed as Factor VIII deficiency and 1 diagnosed later to have Glanzmann's thrombasthenia. Statistical analysis showed significant difference among these two groups’ p-value with respect to age (p-value 0.00) and family history (p-value 0.04- Fisher’s exact test). Both groups had similar postoperative length of stay. Overall bleeding complication rate after optimization was 13.33%. Conclusion: With the help of hematologist and adequate Factor replacement, these children can be managed as daycare. We suggest risks and benefit should be discussed with parents before procedure
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Davis, Stephanie M., Jonas Z. Hines, Melissa Habel, Jonathan M. Grund, Renee Ridzon, Brittney Baack, Jonathan Davitte, et al. "Progress in voluntary medical male circumcision for HIV prevention supported by the US President’s Emergency Plan for AIDS Relief through 2017: longitudinal and recent cross-sectional programme data." BMJ Open 8, no. 8 (August 2018): e021835. http://dx.doi.org/10.1136/bmjopen-2018-021835.
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ObjectiveThis article provides an overview and interpretation of the performance of the US President’s Emergency Plan for AIDS Relief’s (PEPFAR’s) male circumcision programme which has supported the majority of voluntary medical male circumcisions (VMMCs) performed for HIV prevention, from its 2007 inception to 2017, and client characteristics in 2017.DesignLongitudinal collection of routine programme data and disaggregations.Setting14 countries in sub-Saharan Africa with low baseline male circumcision coverage, high HIV prevalence and PEPFAR-supported VMMC programmes.ParticipantsClients of PEPFAR-supported VMMC programmes directed at males aged 10 years and above.Main outcome measuresNumbers of circumcisions performed and disaggregations by age band, result of HIV test offer, procedure technique and follow-up visit attendance.ResultsPEPFAR supported a total of 15 269 720 circumcisions in 14 countries in Southern and Eastern Africa. In 2017, 45% of clients were under 15 years of age, 8% had unknown HIV status, 1% of those tested were HIV+ and 84% returned for a follow-up visit within 14 days of circumcision.ConclusionsOver 15 million VMMCs have been supported by PEPFAR since 2007. VMMC continues to attract primarily young clients. The non-trivial proportion of clients not testing for HIV is expected, and may be reassuring that testing is not being presented as mandatory for access to circumcision, or in some cases reflect test kit stockouts or recent testing elsewhere. While VMMC is extremely safe, achieving the highest possible follow-up rates for early diagnosis and intervention on complications is crucial, and programmes continue to work to raise follow-up rates. The VMMC programme has achieved rapid scale-up but continues to face challenges, and new approaches may be needed to achieve the new Joint United Nations Programme on HIV/AIDS goal of 27 million additional circumcisions through 2020.
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Jones, Patrick, Helen Rooney, and Amr Hawary. "Pediatric Circumcision in the 21st Century National Health Service: A Snapshot of Practice in a United Kingdom Center." Surgery Journal 06, no. 04 (October 2020): e188-e191. http://dx.doi.org/10.1055/s-0040-1721430.
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Abstract Introduction Pediatric circumcision is a commonly performed operation, yet outcomes related to procedures performed for medical indications remain underreported. Aim The aim of this study was to report outcomes of therapeutic circumcision from our center. Methods Prospective registry of elective circumcisions was maintained and analyzed at a single institution in the United Kingdom. Data collected included information on complications (early and late), emergency presentations, and referrals back from primary care services. Results Between August 2015 and June 2019, 300 patients (mean age: 9 years; range: 3–16 years) underwent therapeutic circumcision. The average length of follow-up data available was 2.1 years (range: 6 months to 4 years). The overall complication rate was 4.7% (n = 16). There were no unplanned admissions and no cases returned to the operating room as emergency. Only 1% (n = 3) of patients presented with an early complication (minor bleeding, pain, urinary retention), and 3.7% (n = 11) suffered a late complication (meatal stenosis [2.7%]). All cases of meatal stenosis had lichen sclerosus confirmed on histology. Cosmetic satisfaction was 99%. Conclusion Therapeutic circumcision is an effective procedure in the pediatric population, which carries a low risk of early and late complications. Our study found that meatal stenosis only occurred in those patients with confirmed lichen sclerosus histology.
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Erika and Wina Viqa Sari. "Hubungan Dukungan dan Pengetahuan Orang Tua dengan Motivasi Khitan Siswa MIS Amal Shaleh Perumnas Simalingkar Medan Masa Pandemi Covid-19." Jurnal Indah Sains dan Klinis 2, no. 1 (April 30, 2021): 23–32. http://dx.doi.org/10.52622/jisk.v2i1.12.
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During the Covid-19 pandemic, people in Medan experienced anxiety. This is indicated by the community's low interest in circumcising their children, which is seen from the number of circumcision participants carried out by the Indah Foundation at the IndahMedan College of Health Sciences in 2020, in January with only 12 participants, 9 (June), 15 (October). Likewise on Radio Indah Suara 96.5 FM Perbaungan in December 2019 with 11 people, in June 2020 with 14 people, in October with 15 participants. This paper aims to determine the relationship between parent's support and knowledge for motivating their children to do circumcision. The method is done by looking at the correlation between parent's support and knowledge with the motivation to circumcise the child and seeing how multiple (simultaneous) correlation between the support and knowledge of parents and the motivation to circumcise the child. The author can conclude that the majority of students' parents (55.00%) do not support their children being circumcised during the Covid-19 pandemic, and parents' knowledge of circumcision during the Covid-19 pandemic is still inadequate, seen from the level of understanding of parents regarding circumcision during the Covid-19 pandemic is at a moderate level (66.67%)
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Wiswell, Thomas E., Robert W. Enzenauer, Mark E. Holton, J. Devn Cornish, and Charles T. Hankins. "Declining Frequency of Circumcision: Implications for Changes in the Absolute Incidence and Male to Female Sex Ratio of Urinary Tract Infections in Early Infancy." Pediatrics 79, no. 3 (March 1, 1987): 338–42. http://dx.doi.org/10.1542/peds.79.3.338.
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The results of an investigation examining the circumcision frequency rate and its effect on the incidence of urinary tract infections in a large, widely dispersed population base during the 10-year period since the 1975 report of the American Academy of Pediatrics Ad Hoc Task Force on Circumcision are reported. Our study population included the 427,698 infants born in all United States Army hospitals, worldwide, from Jan 1, 1975, through Dec 31, 1984. There was an initial plateau in the circumcision frequency rate at approximately 85% during the first 4 years of the study period. In the subsequent 6 years there was a steady, significant decrease (P < .001) of 1.4% to 4.0% per year through 1984, when the circumcision frequency rate reached its nadir of 70.5%. There was a concomitant increase in the total number of urinary tract infections among male infants (P < .02) as the circumcision rate declined. This increase was due to the increase in the overall number of uncircumcised boys (who had a greater than 11-fold increased infection rate compared with circumcised boys). During the first half of the study period, there was a female predominance for urinary tract infections from birth onward. As the number of circumcised boys decreased (with a resultant increase in the total number of boys with infection), the male to female ratio of urinary tract infections during the first 3 months of life reversed, reflecting a movement toward a male predominance for infection in early infancy. This is the first, well-documented report of a decreasing rate of circumcisions performed on the American male population. We conclude that the number of urinary tract infections in male infants, as well as the male to female sex ratio, is affected by the circumcision practices of the population examined.
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WILLIAMS, H. STEPHEN. "More on Risks of Circumcision." Pediatrics 85, no. 1 (January 1, 1990): 136. http://dx.doi.org/10.1542/peds.85.1.136.
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To the Editor.— The diligent and thoughtful efforts of Wiswell and his collaborators in pursuing the original observation of Ginsburg and McCracken,1 that urinary tract infections in male infants occurred more frequently among those who were uncircumcised, have led to some rethinking of previous recommendations regarding routine circumcision. In the most recent report, Wiswell and Geschke2 neatly summarize the minimal risk of properly performed circumcisions and provide important new information regarding the serious threat to health and life itself that urinary tract infections pose to afflicted uncircumcised male neonates.
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Rahman, Habib Ur, Hina Iftikhar, Ghazanfar Ali, Mujahid Ali Khoso, Arooj Ahsan, and Naveed Ahmed. "Plastibel Circumcision: Safest Technique in the Infants with the Experienced Hands: A Single Centre Experience." Pakistan Armed Forces Medical Journal 72, SUPPL-2 (June 7, 2022): S329–32. http://dx.doi.org/10.51253/pafmj.v72isuppl-2.6481.
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Objective: To evaluate the safety and efficacy of circumcision done by plastibel technique in infants up till six months of age.
Study Design: Cross-sectional study.
Place and Duration of Study: Department of Surgery, Combined Military Hospital, Multan, from Aug 2019 to Jul 2020
Methodology: The Department of surgery, Combined Military Hospital, Multan, from 2019 to 2020. A sample size of 140 patients was calculated via the EpiTools epidemiological calculator while keeping the significance level at 5% and a confidence level of 95%.
Results: A total of 140 infants were circumcised with the plastibel technique. The age of the infants ranged from 21 days to six months with the mean age of 32.2 ± 10.5 days. Maximum circumcisions were done between 30-90 days of life. The best part of the circumcision was that no complication was observed during the study period.
Conclusion: Plastibel circumcision can be done under local anaesthesia with the best possible safety in infants younger than six months of age.
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Evawere, Sadoh Ayebo, Osifo David Omorogieva Edosa, Fawole Oluwadare Samuel, and Emordi Victor. "Routine childhood immunization knowledge: Do fathers who accompany their children for immunization differ from those who accompany their children for circumcision?" Nigerian Journal of Paediatrics 50, no. 3 (November 2, 2023): 144–50. http://dx.doi.org/10.4314/njp.v50i3.3.
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Background: Paternal involvement in child care activities especially immunization is being advocated as their involvement portend better outcomes. Compliance with circumcision another child care activity is much higher than for childhood immunization.
Method: Fathers who accompanied their children for immunization were recruited at the immunization centre while fathers who accompanied their male infants for circumcision were recruited at Accident and Emergency theatre where circumcisions are performed. Demographic information was obtained as well as information on the knowledge of fathers about immunization.
Results: There were 103 fathers accompanying children for immunization and circumcision respectively. Mean age of those who accompanied for immunization 34.47±5.68 years was significantly younger than 36.91±4.54 years for fathers who accompanied for cirCC –BY 4.0 cumcision p<0.0008. Fathers who accompanied for circumcision were significantly more educated p<0.0001 and were significantly more likely to know the names of the vaccines administered and potential side effect s / complications of vaccines. Fathers who accompanied for immunization were significantly more likely to know the age at commencement and completion of immunization although a significant proportion of both groups were not knowledgeable about these dates.
Conclusion: Majority of fathers were not knowledgeable about immunization. All opportunities for contact with fathers especially when they accompany their children for health care activities should be used to educate them about immunization and its importance.
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Moodley, Keymanthri, and Stuart Rennie. "Penile transplantation as an appropriate response to botched traditional circumcisions in South Africa: an argument against." Journal of Medical Ethics 44, no. 2 (July 29, 2017): 86–90. http://dx.doi.org/10.1136/medethics-2016-103515.
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Traditional male circumcision is a deeply entrenched cultural practice in South Africa. In recent times, there have been increasing numbers of botched circumcisions by untrained and unscrupulous practitioners, leading to genital mutilation and often, the need for penile amputation. Hailed as a world’s first, a team of surgeons conducted the first successful penile transplant in Cape Town, South Africa in 2015. Despite the euphoria of this surgical victory, concerns about the use of this costly intervention in a context of severe resource constraints have been raised. In this paper, we explore some of the ethical implications of penile transplants as a clinical and public health response to the adverse consequences of traditional male circumcision. Given the current fiscal deficits in healthcare and public health sectors, how can one justify costly, high-technology interventions for conditions affecting a small section of the population? Since botched traditional male circumcisions are preventable, is a focus on penile transplantation as a form of treatment reasonable? Finally, do such interventions create undue expectations and false hope among a highly vulnerable and stigmatised group of young men? In this paper, we argue that given limited healthcare resources in South Africa and competing healthcare needs, prevention is a more appropriate response to botched traditional circumcisions than penile transplants.
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Abara, Emmanuel O. "Prepuce health and childhood circumcision: Choices in Canada." Canadian Urological Association Journal 11, no. 1-2S (February 16, 2017): 55. http://dx.doi.org/10.5489/cuaj.4447.
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Introduction: Worldwide, almost 100% of boys are born with penises with a “hood” called prepuce or foreskin. In the course of the boy’s life, the prepuce can be circumcised, can become affected by diseased (e.g., phimosis), or a can become infected and hurt the neonate (and his sexual partner) in adulthood. The objectives of this report are to: 1) review the state, function, fate, and care of the prepuce in childhood, with focus on the neonate, in Canada; 2) understand the current practice of childhood male circumcision in terms of age, indications, performers, techniques, outcomes, and education; and 3) consider ways to sustain a good healthcare professional-parental dialogue for safe practices that are accessible, acceptable, and culturally sensitive in the care of the prepuce.Methods: A literature review was carried out in the English language through the major databases: PubMed (MEDLINE), EMBASE, the Cochrane Library, CINAHL, Web of Science (WOS) Core Collection, LILAC, WHO/UNAIDS, Clinical Trials (www.clinicaltrials.gov), Google Scholar, and grey literature. Search words included: prepuce, diseases of prepuce, prepuce in the neonate, prepuce in the neonate in Canada, male circumcision, childhood male circumcision, neonatal circumcision, neonatal circumcisionin Canada, complications of neonatal circumcision in Canada, and circumcision adverse events.Results: From 1970‒1999, three of 10 Canadian newborn males were circumcised for religious, cultural, and medical reasons. The rest of the neonates, if alive, are living with their prepuce; <4% expected to require treatment for afflictions of the prepuce at some point. There are several providers of circumcision with different levels of training and competencies and using a diversity of devices and techniques. Neonatal and childhood circumcision in Canada is carried out to fulfill parental wishes, as well as for medical, religious, and cultural reasons. Appropriate informed consent and education regarding choices of care of the neonatal prepuce and genitals are vital.Conclusions: Going by current prevalent rate of circumcision in Canada, most Canadian newborn males are likely to live out their lives with an intact prepuce. Despite the age-old debate, childhoodcircumcision is likely to remain. There is need for careful and proper discussion of the potential risks and benefits, including alternatives, costs, and personal/psychological factors. Acceptance, access, andjudicious choices in a culturally sensitive environment will offer the Canadian neonate desirable care of the prepuce for life.
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Soon, Isaac T. "“In strength” not “by force”: Re-reading the circumcision of the uncircumcised ἐν ἰσχύι in 1 Macc 2:46." Journal for the Study of the Pseudepigrapha 29, no. 3 (March 2020): 149–67. http://dx.doi.org/10.1177/0951820720902086.
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This article challenges the dominant reading of 1 Macc 2:46, both that (a) the syntagm ἐν ἰσχύι means coercion and that (b) the literary context of 1 Maccabees understands the circumcising of the uncircumcised in 2:46 as coercive. An analysis of the lexical semantics of ἐν ἰσχύι in ancient Greek literature shows that it never referred to coercion, but primarily referred to the means by which an action was accomplished (“by strength/might/power”). Admittedly, ἐν ἰσχύι can occur in coercive contexts (e.g. Wis 16:16). However, coercion is not a part of the syntagm itself, but arises out of the surrounding literary circumstances. Rather than as one who forces circumcision upon others, the literary context of 1 Macc 2:46 presents Mattathias as a liberator who reinstates circumcision for those who had been prevented from circumcising their children due to persecution. Josephus, our earliest reception of 1 Macc 2:46, is a witness to this reading.
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Widjajanto, Pudjo Hagung, Nurul Hadi, Ivan Onggo Saputro, Agus Wibowo, Nur Budiono, Agus Tusino, and David Wijaya Sutowo. "Circumcision in subject with hemophilia: the Yogyakarta Method." Paediatrica Indonesiana 64, no. 3 (May 30, 2024): 244–9. http://dx.doi.org/10.14238/pi64.3.2024.244-9.
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Background Circumcision is one of the most common surgical procedures in boys in Indonesia. In cases patient with hemophilia (PWH), doctors tend to avoid this procedure due to increased bleeding tendency. In 2007, we developed a protocol for clotting factor concentrate (CFC) administration for circumcision in SWH, namely, the “Yogyakarta Method.” Objective To evaluate the outcomes of the Yogyakarta Method for circumcising PWH. Methods This descriptive study was based on medical records of PWH who underwent circumcision at Dr. Sardjito Hospital (DSH), Yogyakarta and 3 surrounding hospitals under DSH supervision from 2008-2017 and 2018-2022. Diagnoses of hemophilia were based on clinical findings and factor assays. Subjects with hemophilia A received factor VIII (25 IU/kg/dose) and those with hemophilia B received factor IX (50 IU/kg/dose) before, during and after the procedure. In addition, patients received tranexamic acid (15 mg/kg/dose). Circumcision was performed by a pediatric surgeon or urologist. Results From 2008-2017, 28 PWH underwent circumcision, 14/28 of whom were in DSH. Twenty-six patients had hemophilia A and 2 had hemophilia B. Their severities were mild (12 subjects), moderate (10), and severe (6). Subjects’ median age was 10.5 (5-19) years and their median CFC use was 8 (range 7-10) doses in hemophilia A and 4 (range 4-5) doses in hemophilia B patients. Three of 28 PWH had bleeding episodes after the procedure. Following the encouraging results from the initial 2008-2017 study period, most of PWH circumcised in 2018-2022 underwent the procedure in the same 3 district hospitals rather than at DSH (21/28 subjects), and had similar CFC consumption. Only 1 bleeding episode occurred after the procedure during the second study period. Conclusion The Yogyakarta method is safe and sufficient to control bleeding in circumcision of PWH. This method is also suitable in a district hospital setting.
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Kim, Hana, Adam Branscum, F. DeWolfe Miller, and Diego F. Cuadros. "Geospatial assessment of the voluntary medical male circumcision programme in Tanzania, 2011–2016." BMJ Global Health 4, no. 6 (November 2019): e001922. http://dx.doi.org/10.1136/bmjgh-2019-001922.
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IntroductionTanzania is one of the 14 priority countries in sub-Saharan Africa scaling up voluntary medical male circumcision (VMMC) for HIV prevention. In this study, we assessed the progress of VMMC by evaluating changes in the spatial structure of male circumcision (MC) prevalence and identifying age groups with low MC uptake.MethodsWe use data from two waves of the Demographic and Health Survey (DHS) conducted in Tanzania in 2011–2012 and 2015–2016. MC incidence rate was estimated using a method developed to calculate incidence rates from two successive cross-sectional surveys. Continuous surface maps of MC prevalence were generated for both DHS waves and compared with identified areas with high MC prevalence changes and high density of uncircumcised males.ResultsNational MC prevalence in Tanzania increased from 73.5% in 2011–2012 to 80.0% in 2015–2016. The estimated national MC incidence rate was 4.6 circumcisions per 100 person-years (py). The lowest circumcision rate was observed in males aged 20–24 years, with 0.61 circumcisions per 100 py. An estimated 1 567 253 males aged 15–49 years residing in low-MC prevalence areas were uncircumcised in 2015–2016.ConclusionTanzania has shown substantial progress in the implementation of VMMC. However, extensive spatial variation of MC prevalence still exists in the country, with some areas having an MC prevalence <60%. Here, we identified locations where VMMC needs to be intensified to reach the ~1.5 million uncircumcised males age 15–49 living in these low-MC areas, particularly for men aged 20–34.
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Meel, Banwari. "Fatality as a Result of Traditional Circumcision in Mthatha Region in South Africa (2004-2014)." Indian Journal of Forensic Medicine and Pathology 15, no. 1 (March 15, 2022): 899–904. http://dx.doi.org/10.21088/ifjmp.0974.3383.15122.17.
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context: The practice of culture is to protect people and preserve life. No culture allowed becoming a danger to human beings, sacrificing young lives year after year. The community keeps turning a blind eye to one death after the other because of tradition and culture. Objective: The main objective of the study was to describe the deaths that occurred between 2004 and 20014 due to traditional circumcisions. method: This is a record review descriptive study. The data were collected from the Forensic Pathology Laboratory of Hospital Complex from 2004 to 2014. results: A hundred and fifty-five cases of circumcision-related deaths were reported over a period of 11 years (2004-14) in the region of South Africa. The causes of death included septicaemia (66-42.6%), blunt trauma (6-3.9%), dehydration (4-2.6%), renal failure (3-1.9%), hypothermia (2-1.2%), and pulmonary thrombo-embolism (2-1.2%). conclusions: Death due to circumcision is unethical and unacceptable conduct due to unacceptable cultural practices. This practice must be banned. A strong political message needs to be sent to the community as well as to the practitioners of circumcision.