View source for Circumcision risks

{{Incomplete}}
This article wants to offer a comprehensive overview of risks which can occur by undergoing a [[circumcision]]. This page is a landing page for those who want to find a quick overview about [[circumcision]] risks. Chances are that information given here is shown in more detail in other IntactiWiki articles.

Please bear in mind that infants are not born with a diseased [[penis]] that requires surgery. There are no medical indications for infant circumcision and few in later life. Infant circumcision is a medically-unnecssary, non-therapeutic amputation of functional tissue that does not treat or prevent disease. It has risks and complications but no upside benefit.

== General risks ==
* Loss of the [[foreskin]] (100% [[complication]] rate)
* [[Circumcision scar|Operation scar]] (100% [[complication]] rate)
* Loss of the [[frenulum]]
* Loss of protection of the [[glans]]
* Reduction of the [[penis]]
* [[Keratinization]] of the [[glans]]
* Loss of [[Foreskin sensitivity| sensation]]
* [[Financial incentive| Loss of money for a medically not indicated surgery]]
* [[Foreskin restoration|Restoration of the foreskin]] not 100% possible and very time-consuming (adults)
* Risk of [[penile frostbite]]<ref>{{REFweb
 |url=https://pagesix.com/2023/01/05/prince-harry-reveals-whether-hes-circumcised-in-bombshell-spare-memoir/
 |title=Prince Harry reveals whether he’s circumcised in bombshell ‘Spare’ memoir
 |last=Gostin
 |first=Nick
 |date=2023-01-05
 |accessdate=2023-01-26
}}</ref>

== Operative risks ==

* [[Death]]
* [[Amputation]] of the [[penis]]
* [[Amputation]] of the [[glans]]
* [http://www.cirp.org/library/complications/wilson1/ Amputation of excess skin or denudation]
* [http://www.cirp.org/library/complications/bradley/ Burn of the penis after usage of electrocautery]
* [[Heart attack]]
* [[Shock]] or coma due to the extreme [[pain]] (newborn circumcision)

* Because [[circumcision]] is type of surgery always, it also encompasses all the basic risks of surgery.
:* [http://www.cirp.org/library/complications/woodside2/ Infection]
:* [[Bleeding]], excess bleeding
:* Surgical mishap

== Post-operative risks (A-Z) ==
* Abnormal healing
* [http://www.circumstitions.com/Restric/Botched1sb.html Adhesions between the shaft and the glans]
* Brain damage (permanent) after [[herpes]] infection (newborn circumcision with [[Metzitzah b'peh]])
* Chlamydiaceae infections
* Chordee
* Deformation of the [[penis]]
* Early ablactation (weaning) (newborn circumcision)
* Epispadias
* Excessive [[foreskin]] removed (leads to deformation)
* [Fistulas]
* Genital warts
* Gonorrhea
* [[Herpes]] infection (newborn circumcision with [[Metzitzah b'peh]])
* [[Hypospadias]]
* Impetigo
* Impotence
* Inclusion cysts
* [http://www.cirp.org/library/death/sauer1/ Infection]
* Insufficient foreskin removed (re-surgery often done)
* [[Intraperitoneal rupture of the urinary bladder]]
* Loss of penile sensitivity
* Lubricants required for [[masturbation]] and intercourse
* Lung tear due to extreme cries of pain (newborn circumcision)
* [[Lymphoedema]]
* [[Meatal stenosis]] (20% [[complication]] rate)
* Meatal ulcer
* [http://www.cirp.org/library/complications/brennemann1/ Meatitis]
* [[Necrosis]] of the penis
* Oedema of the glans
* [http://www.cirp.org/library/complications/blalock1/ Phimosis]
* [[Erection| Pain in erected state of the penis]]
* Risk of required re-surgery
* [http://www.cirp.org/library/complications/stinson/ Sexual dysfunction]
* [[Skin bridges]] between the shaft and the glans
* [[Sudden Infant Death Syndrome]]<ref>{{REFweb
 |url=https://medicalxpress.com/news/2019-01-neonatal-circumcision-sudden-infant-death.html
 |title=Neonatal circumcision could increase the risk of sudden infant death syndrome in babies – new research
 |first=Eran
 |last=Elhaik
 |publisher=MedicalXpress
 |date=2019-01-11
 |accessdate=2020-07-02
}}</ref>
* Syphilis
* Tummy wall tear due to extreme cries of pain (newborn circumcision)
* Urethritus
* Urethrocutaneous fistula
* Urinary retention (this has caused deaths)
* ...

== Psychological risks ==
=== Immediate risks ===
* [[PTSD]] due to newborn [[trauma]]
* [http://www.cirp.org/library/pain/fitzgerald2/ Brain damage due to the extreme pain] (newborn circumcision without effective anesthesia)
* Loss of bonding and trust to parents
* Nipple confusion (newborn circumcision)
* Frustration due to sexual dysfunction
* [https://yorkspace.library.yorku.ca/xmlui/bitstream/handle/10315/7941/KAT036.pdf?sequence=1&origin=publication_detail Lowered pain sensitivity threshold](newborn circumcision)

=== Delayed risks ===
* Feelings of being cheated, robbed, abandoned and unprotected by the own parents
* [[Collective Cognitive Dissonance|Cognitive dissonance]]
* [[Circumcision coma]]
* [[Psychological_issues_of_male_circumcision#Circumcision_trauma_in_adults|Circumcision trauma in adults]]
* Impotence due to psychological bad feelings of being inferior
* Depression
* [[Suicide]]
* Altered adult socio-affective processing<ref>{{REFjournal
 |url=https://vbn.aau.dk/en/publications/neonatal-male-circumcision-is-associated-with-altered-adult-socio
 |title=Neonatal male circumcision is associated with altered adult socio-affective processing
 |first=Alessandro
 |init=A
 |last=Miani
 |first2=Gian Antonio
 |init2=GA
 |last2=Di Bernardo
 |first3=Astrid Ditte
 |init3=AD
 |last3=Højgaard
 |first4=Brian D.
 |init4=BD
 |last4=Earp
 |author4-link=Brian D. Earp
 |first5=Paul J.
 |init5=PJ
 |last5=Zak
 |first6=Anne M.
 |init6=AM
 |last6=Landau
 |first7=Jørgen
 |init7=J
 |last7=Hoppe
 |first8=Michael
 |init8=M
 |last8=Winterdahl
 |journal=J Heliyon
 |volume=6
 |issue=11
 |article=e05566
 |date=2020-11-20
 |DOI=10.1016/j.heliyon.2020.e05566
 |accessdate=2020-12-20
}}</ref>

== Statistical risks ==
Out of 100 circumcised boys:<ref name="DrMomma2010">{{REFweb
 |url=http://www.drmomma.org/2010/01/cut-vs-intact-outcome-statistics.html
 |title=Intact vs. Circumcised Outcome Statistics 
 |website=Dr. Momma
 |date=2010-01
 |accessdate=2021-06-07
}}</ref>
* 75 will not readily breastfeed post-op.
* 55 will have adverse reactions from the surgery.
* 35 will have some degree of post-op hemorrhaging.
* 31 will develop meatal ulcers.
* 10 will need to have repeat circumcision surgery to fix surgical errors.
* 8 will suffer infection at the surgical site.
* 3 will develop post-operative [[phimosis]].
* 2 will have more serious complications (seizure, [[heart attack]], stroke, loss of [[penis]], [[death]]).
* 1 will require additional immediate surgery and sutures to stop hemorrhage.
* 1 will develop fibrosis.
* 1 will be treated with antibiotics for a [[UTI]] (urinary tract infection).

Of those who receive anesthesia before surgery, some will have adverse reactions to the pain medication.

Out of 100 intact boys:<ref name="DrMomma2010"/>
* 2 will be treated with antibiotics for a [[UTI]] (fewer if the [[foreskin]] is never forcibly retracted).
* 1 will be told to get [[circumcised]] later in life for one reason or another (fewer if the foreskin is never forcibly retracted).

== AAP confirms complications ==
The [[AAP]] offers a coding newsletter for those who encode medical diagnoses in ICD codes. They offer a "[https://publications.aap.org/codingnews/article-abstract/12/9/3/27080/Subspecialty-Corner-Coding-for-Complications-of?redirectedFrom=fulltext Subspecialty Corner: Coding for Complications of Neonatal Circumcision]"<ref>{{REFjournal
 |url=https://coding.solutions.aap.org/article.aspx?articleid=2629478
 |title=Subspecialty Corner: Coding for Complications of Neonatal Circumcision
 |journal=AAP Pediatric Coding Newsletter
 |volume12
 |issue=9
 |date=2017
 |accessdate=2020-02-24
}}</ref> which definitely confirms that even the [[AAP]] knows of a bunch of [[complication]]s.

== Complication rates ==
In fact, of course, not all possible [[complication]] rates have the same frequency and therefore not the same relevance. It is necessary to collect statistics on which complications are serious. Basically, however, it should be noted that circumcision without a [[medical indication]] is the most unnecessary complication in itself, with a '''100% rate'''.

The German Academy of Children and Youth Medicine (DAKJ) (2012) conducted an internet survey of medical practices and determined a serious complication rate of '''approx. 6%''' based on the reported data.<ref>{{REFweb
 |url=https://www.dakj.de/stellungnahmen/beschneidung-von-minderjaehrigen-jungen/
 |title=Beschneidung von minderjährigen Jungen
 |trans-title=Circumcision of minor boys
 |language=German
 |date=2016-12-21
 |accessdate=2020-11-24
}}</ref> Thorup et al. (2013) report that '''about 5.1%''' of the recorded complications were significant complications.<ref>{{REFjournal
 |last=Thorup
 |init=J
 |last2=Cortes-Thorup
 |init2=S
 |last3=Rasmussen-Ifaoui
 |init3=JB
 |date=2013
 |title=Complication rate after circumcision in a paediatric surgical setting should not be neglected
 |url=https://pubmed.ncbi.nlm.nih.gov/23905566/
 |journal=Dan Med J
 |volume=60
 |pages=1-3
 |pubmedID=23905566
 |accessdate=2020-11-24
}}</ref> Zöller et al. (2014) analyzed patient data in a retrospective and find that '''the complication rate after male circumcision is relevant'''.<ref>{{REFjournal
 |last=Zöller
 |init=C
 |last2=Fernandez
 |init2=G
 |last3=Peteresen
 |init3=C
 |last4=Ure
 |init4=B
 |title=Stationäre Behandlung bei Komplikationen nach männlicher Beschneidung: Retrospektive Analyse eines deutschen Referenzzentrums
 |trans-title=Inpatient treatment for complications after male circumcision: Retrospective analysis of a German reference center
 |language=German
 |url=https://www.egms.de/static/de/meetings/dgch2014/14dgch256.shtml
 |publisher=Deutsche Gesellschaft für Chirurgie
 |date=2014-03-21
 |accessdate=2020-11-24
}}</ref>

Patel (1966) reported a complication rate of '''55%''' in a series at [https://kingstonhsc.ca/ Kingston General Hospital] in Ontariɔ.<ref name="patel1966">
{{REFjournal
 |last=Patel
 |first=Hawa
 |init=H
 |author-link=
 |etal=no
 |title=The problem of routine circumcision
 |trans-title=
 |language=English
 |journal=Canad Med Assoct J
 |location=
 |date=1966-09-10
 |volume=95
 |issue=11
 |pages=576-81
 |url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1936659/pdf/canmedaj01181-0029.pdf
 |archived=
 |quote=
 |pubmedID=5947615
 |pubmedCID=1936659
 |DOI=
 |accessdate=2020-11-25
}}</ref>

Williams & Kapila (1993) reviewed the complications of circumcision. They estimated a complication rate of '''2 to 10 percent'''<ref name="williams1993">{{REFjournal
 |last=Williams
 |first=Nigel
 |init=N
 |author-link=
 |last2=Kapila
 |first2=Leela
 |init2=L
 |author2-link
 |etal=no
 |title=Complications of circumcision.
 |trans-title=
 |language=English
 |journal= Brit J Surg
 |location=
 |date=1993
 |volume=80
 |issue=10
 |pages=1231-6
 |url=http://www.cirp.org/library/complications/williams-kapila/
 |archived=
 |quote=
 |pubmedID=8242285 
 |pubmedCID=
 |DOI=10.1002/bjs.1800801005
 |accessdate=2020-11-26
}}</ref>

Okeke et al. (2006) investigated the incidence of circumcision complications in Ibadan, Nigeria. They reported a complication rate of '''20.2 percent'''<ref ="okeke2006">{{REFjournal
 |last=Okeke
 |first=Linus
 |init=L
 |author-link=
 |last2=Asinnobi
 |first2=Adanze
 |init2=A
 |author2-link=
 |last3=Ikeurerowo
 |first3=Odunayo
 |init3=O
 |author3-link=
 |etal=no
 |title=Epidemiology of complications of male circumcision in Ibadan, Nigeria
 |trans-title=
 |language=English
 |journal=BMC Urol.
 |location=
 |date=2006
 |volume=6
 |issue=21
 |pages=
 |url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1560152/
 |archived=
 |quote=
 |pubmedID=16934157
 |pubmedCID=1560152
 |DOI=10.1186/1471-2490-6-21
 |accessdate=2020-11-26
}}</ref>

Lau et al. (2018) used the Utah [http://stats.health.utah.gov/about-the-data/ All-Payer Claims Database] to determine the incidence of circumcision and the percentage of complications for the state of Utah. The authors reported an incidence of neonatal circumcision of in Utah of '''29 percent''' and an incidence of complications of '''11.5 percent'''.<ref name="lau2018">{{REFjournal
 |last=Lau
 |first=Glen
 |init=G
 |author-link=
 |last2=Kim
 |first2=Jaewhan
 |init2=J
 |author2-link=
 |last3=Shaeffer
 |first3=Anthony
 |init3=A
 |author3-link=
 |etal=no
 |title=Identification of circumcision complications using a regional claims database
 |trans-title=
 |language=English
 |journal=Societies for Pediatric Urology
 |location=
 |date=2018
 |volume=
 |issue=
 |pages=
 |url=https://spuonline.org/abstracts/2018/P21.cgi
 |archived=
 |quote=
 |pubmedID=
 |pubmedCID=
 |DOI=
 |accessdate=2020-11-26
}}</ref>

{{SEEALSO}}

* [[Complication]]
* [[Circumcision botches]]
* [[Documented severe complications of circumcision]]
* [[Fatalities]]
* [[Psychological issues of male circumcision]]
* [[Risks and complications]]
* [[Sexual effects of circumcision]]

{{LINKS}}
* {{REFweb
 |url=https://med.stanford.edu/newborns/professional-education/circumcision/complications.html
 |title=Complications of Circumcision
 |publisher={{UNI|Stanford University|SU}}
 |accessdate=2020-02-20
}}
* {{REFweb
 |url=http://circumstitions.com/all.html
 |title=More than 600 Circumstitions (Reasons Given for Circumcising a Male)
 |publisher=Circumstitions
 |accessdate=2020-03-19
}}

{{REF}}

[[Category:Parental information]]
[[Category:Circumcision risk]]
[[Category:Complication]] 

[[de:Beschneidungsrisiken]]