Difference between revisions of "Circumcision risks"
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| − | 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. | + | 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 == | == General risks == | ||
| Line 9: | Line 11: | ||
* Reduction of the [[penis]] | * Reduction of the [[penis]] | ||
* [[Keratinization]] of the [[glans]] | * [[Keratinization]] of the [[glans]] | ||
| − | * Loss of sensation | + | * Loss of [[Foreskin sensitivity| sensation]] |
* [[Financial incentive| Loss of money for a medically not indicated surgery]] | * [[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) | * [[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 == | == Operative risks == | ||
| + | |||
* [[Death]] | * [[Death]] | ||
| − | * Amputation of the [[penis]] | + | * [[Amputation]] of the [[penis]] |
| − | * Amputation of the [[glans]] | + | * [[Amputation]] of the [[glans]] |
* [http://www.cirp.org/library/complications/wilson1/ Amputation of excess skin or denudation] | * [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] | * [http://www.cirp.org/library/complications/bradley/ Burn of the penis after usage of electrocautery] | ||
| − | * Shock or coma due to the extreme pain (newborn circumcision) | + | * [[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. | * Because [[circumcision]] is type of surgery always, it also encompasses all the basic risks of surgery. | ||
| Line 32: | Line 44: | ||
* Chlamydiaceae infections | * Chlamydiaceae infections | ||
* Chordee | * Chordee | ||
| − | * Deformation of the penis | + | * Deformation of the [[penis]] |
* Early ablactation (weaning) (newborn circumcision) | * Early ablactation (weaning) (newborn circumcision) | ||
* Epispadias | * Epispadias | ||
| − | * Excessive foreskin removed (leads to deformation) | + | * Excessive [[foreskin]] removed (leads to deformation) |
* [Fistulas] | * [Fistulas] | ||
* Genital warts | * Genital warts | ||
| Line 54: | Line 66: | ||
* Meatal ulcer | * Meatal ulcer | ||
* [http://www.cirp.org/library/complications/brennemann1/ Meatitis] | * [http://www.cirp.org/library/complications/brennemann1/ Meatitis] | ||
| − | * Necrosis of the penis | + | * [[Necrosis]] of the penis |
* Oedema of the glans | * Oedema of the glans | ||
* [http://www.cirp.org/library/complications/blalock1/ Phimosis] | * [http://www.cirp.org/library/complications/blalock1/ Phimosis] | ||
| − | * Pain in erected state of the penis | + | * [[Erection| Pain in erected state of the penis]] |
* Risk of required re-surgery | * Risk of required re-surgery | ||
* [http://www.cirp.org/library/complications/stinson/ Sexual dysfunction] | * [http://www.cirp.org/library/complications/stinson/ Sexual dysfunction] | ||
* [[Skin bridges]] between the shaft and the glans | * [[Skin bridges]] between the shaft and the glans | ||
| − | * Sudden Infant Death Syndrome<ref>{{REFweb | + | * [[Sudden Infant Death Syndrome]]<ref>{{REFweb |
|url=https://medicalxpress.com/news/2019-01-neonatal-circumcision-sudden-infant-death.html | |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 | |title=Neonatal circumcision could increase the risk of sudden infant death syndrome in babies – new research | ||
| Line 79: | Line 91: | ||
== Psychological risks == | == Psychological risks == | ||
=== Immediate risks === | === Immediate risks === | ||
| − | * [[PTSD]] due to newborn trauma | + | * [[PTSD]] due to newborn [[trauma]] |
* [http://www.cirp.org/library/pain/fitzgerald2/ Brain damage due to the extreme pain] (newborn circumcision without effective anesthesia) | * [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 | * Loss of bonding and trust to parents | ||
| Line 93: | Line 105: | ||
* Impotence due to psychological bad feelings of being inferior | * Impotence due to psychological bad feelings of being inferior | ||
* Depression | * Depression | ||
| − | * Suicide | + | * [[Suicide]] |
* Altered adult socio-affective processing<ref>{{REFjournal | * Altered adult socio-affective processing<ref>{{REFjournal | ||
|url=https://vbn.aau.dk/en/publications/neonatal-male-circumcision-is-associated-with-altered-adult-socio | |url=https://vbn.aau.dk/en/publications/neonatal-male-circumcision-is-associated-with-altered-adult-socio | ||
| Line 130: | Line 142: | ||
|accessdate=2020-12-20 | |accessdate=2020-12-20 | ||
}}</ref> | }}</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 == | == AAP confirms complications == | ||
| − | The [[AAP]] offers a coding newsletter for those who encode medical diagnoses in ICD codes. They offer a "Subspecialty Corner: Coding for Complications of Neonatal Circumcision"<ref>{{REFjournal | + | 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 | |url=https://coding.solutions.aap.org/article.aspx?articleid=2629478 | ||
|title=Subspecialty Corner: Coding for Complications of Neonatal Circumcision | |title=Subspecialty Corner: Coding for Complications of Neonatal Circumcision | ||
| Line 143: | Line 181: | ||
== Complication rates == | == 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'''. | + | 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 | 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 | ||
| Line 152: | Line 190: | ||
|date=2016-12-21 | |date=2016-12-21 | ||
|accessdate=2020-11-24 | |accessdate=2020-11-24 | ||
| − | }}</ref> Thorup | + | }}</ref> Thorup et al. (2013) report that '''about 5.1%''' of the recorded complications were significant complications.<ref>{{REFjournal |
|last=Thorup | |last=Thorup | ||
|init=J | |init=J | ||
| Line 167: | Line 205: | ||
|pubmedID=23905566 | |pubmedID=23905566 | ||
|accessdate=2020-11-24 | |accessdate=2020-11-24 | ||
| − | }}</ref> Zöller | + | }}</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 | |last=Zöller | ||
|init=C | |init=C | ||
| Line 188: | Line 226: | ||
{{REFjournal | {{REFjournal | ||
|last=Patel | |last=Patel | ||
| − | |||
|first=Hawa | |first=Hawa | ||
| + | |init=H | ||
|author-link= | |author-link= | ||
|etal=no | |etal=no | ||
| Line 212: | Line 250: | ||
Williams & Kapila (1993) reviewed the complications of circumcision. They estimated a complication rate of '''2 to 10 percent'''<ref name="williams1993">{{REFjournal | Williams & Kapila (1993) reviewed the complications of circumcision. They estimated a complication rate of '''2 to 10 percent'''<ref name="williams1993">{{REFjournal | ||
|last=Williams | |last=Williams | ||
| − | |||
|first=Nigel | |first=Nigel | ||
| + | |init=N | ||
|author-link= | |author-link= | ||
|last2=Kapila | |last2=Kapila | ||
| − | |||
|first2=Leela | |first2=Leela | ||
| + | |init2=L | ||
|author2-link | |author2-link | ||
|etal=no | |etal=no | ||
| Line 238: | Line 276: | ||
}}</ref> | }}</ref> | ||
| − | Okeke | + | 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 | |last=Okeke | ||
| − | |||
|first=Linus | |first=Linus | ||
| + | |init=L | ||
|author-link= | |author-link= | ||
|last2=Asinnobi | |last2=Asinnobi | ||
| − | |||
|first2=Adanze | |first2=Adanze | ||
| + | |init2=A | ||
|author2-link= | |author2-link= | ||
|last3=Ikeurerowo | |last3=Ikeurerowo | ||
| − | |||
|first3=Odunayo | |first3=Odunayo | ||
| + | |init3=O | ||
|author3-link= | |author3-link= | ||
| − | |||
|etal=no | |etal=no | ||
|title=Epidemiology of complications of male circumcision in Ibadan, Nigeria | |title=Epidemiology of complications of male circumcision in Ibadan, Nigeria | ||
| Line 271: | Line 308: | ||
}}</ref> | }}</ref> | ||
| − | Lau | + | 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 | |last=Lau | ||
| − | |||
|first=Glen | |first=Glen | ||
| + | |init=G | ||
|author-link= | |author-link= | ||
|last2=Kim | |last2=Kim | ||
| − | |||
|first2=Jaewhan | |first2=Jaewhan | ||
| + | |init2=J | ||
|author2-link= | |author2-link= | ||
|last3=Shaeffer | |last3=Shaeffer | ||
| − | | | + | |first3=Anthony |
| − | | | + | |init3=A |
|author3-link= | |author3-link= | ||
|etal=no | |etal=no | ||
| Line 317: | Line 354: | ||
|url=https://med.stanford.edu/newborns/professional-education/circumcision/complications.html | |url=https://med.stanford.edu/newborns/professional-education/circumcision/complications.html | ||
|title=Complications of Circumcision | |title=Complications of Circumcision | ||
| − | |publisher=Stanford University | + | |publisher={{UNI|Stanford University|SU}} |
|accessdate=2020-02-20 | |accessdate=2020-02-20 | ||
}} | }} | ||
| Line 328: | Line 365: | ||
{{REF}} | {{REF}} | ||
| − | |||
[[Category:Parental information]] | [[Category:Parental information]] | ||
[[Category:Circumcision risk]] | [[Category:Circumcision risk]] | ||
| + | [[Category:Complication]] | ||
[[de:Beschneidungsrisiken]] | [[de:Beschneidungsrisiken]] | ||
Latest revision as of 12:50, 27 July 2024
Work in progress: The following information does not claim to be complete. More content will be added gradually.
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.
Contents
General risks
- Loss of the foreskin (100% complication rate)
- 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 sensation
- Loss of money for a medically not indicated surgery
- Restoration of the foreskin not 100% possible and very time-consuming (adults)
- Risk of penile frostbite[1]
Operative risks
- Death
- Amputation of the penis
- Amputation of the glans
- Amputation of excess skin or denudation
- 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.
Post-operative risks (A-Z)
- Abnormal healing
- 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
- 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
- Meatitis
- Necrosis of the penis
- Oedema of the glans
- Phimosis
- Pain in erected state of the penis
- Risk of required re-surgery
- Sexual dysfunction
- Skin bridges between the shaft and the glans
- Sudden Infant Death Syndrome[2]
- 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
- 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
- Lowered pain sensitivity threshold(newborn circumcision)
Delayed risks
- Feelings of being cheated, robbed, abandoned and unprotected by the own parents
- Cognitive dissonance
- Circumcision coma
- Circumcision trauma in adults
- Impotence due to psychological bad feelings of being inferior
- Depression
- Suicide
- Altered adult socio-affective processing[3]
Statistical risks
Out of 100 circumcised boys:[4]
- 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:[4]
- 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 "Subspecialty Corner: Coding for Complications of Neonatal Circumcision"[5] which definitely confirms that even the AAP knows of a bunch of complications.
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.[6] Thorup et al. (2013) report that about 5.1% of the recorded complications were significant complications.[7] Zöller et al. (2014) analyzed patient data in a retrospective and find that the complication rate after male circumcision is relevant.[8]
Patel (1966) reported a complication rate of 55% in a series at Kingston General Hospital in Ontariɔ.[9]
Williams & Kapila (1993) reviewed the complications of circumcision. They estimated a complication rate of 2 to 10 percent[10]
Okeke et al. (2006) investigated the incidence of circumcision complications in Ibadan, Nigeria. They reported a complication rate of 20.2 percent[11]
Lau et al. (2018) used the Utah 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.[12]
See also
- Complication
- Circumcision botches
- Documented severe complications of circumcision
- Fatalities
- Psychological issues of male circumcision
- Risks and complications
- Sexual effects of circumcision
External links
Complications of Circumcision
, Stanford University. Retrieved 20 February 2020.-
More than 600 Circumstitions (Reasons Given for Circumcising a Male)
, Circumstitions. Retrieved 19 March 2020.
References
- ↑ Gostin, Nick (5 January 2023).
Prince Harry reveals whether he’s circumcised in bombshell ‘Spare’ memoir
. Retrieved 26 January 2023. - ↑ Elhaik, Eran (11 January 2019).
Neonatal circumcision could increase the risk of sudden infant death syndrome in babies – new research
, MedicalXpress. Retrieved 2 July 2020. - ↑
Miani A, Di Bernardo GA, Højgaard AD, Earp BD, Zak PJ, Landau AM, Hoppe J, Winterdahl M. Neonatal male circumcision is associated with altered adult socio-affective processing. J Heliyon. 20 November 2020; 6(11): [e05566]. DOI. Retrieved 20 December 2020.
- ↑ a b (January 2010).
Intact vs. Circumcised Outcome Statistics
, Dr. Momma. Retrieved 7 June 2021. - ↑ Subspecialty Corner: Coding for Complications of Neonatal Circumcision. AAP Pediatric Coding Newsletter. 2017; (9) Retrieved 24 February 2020.
- ↑ (21 December 2016).
Beschneidung von minderjährigen Jungen
[Circumcision of minor boys] (German). Retrieved 24 November 2020. - ↑ Thorup J, Cortes-Thorup S, Rasmussen-Ifaoui JB. Complication rate after circumcision in a paediatric surgical setting should not be neglected. Dan Med J. 2013; 60: 1-3. PMID. Retrieved 24 November 2020.
- ↑ Zöller C, Fernandez G, Peteresen C, Ure B. (Deutsche Gesellschaft für Chirurgie) Stationäre Behandlung bei Komplikationen nach männlicher Beschneidung: Retrospektive Analyse eines deutschen Referenzzentrums [Inpatient treatment for complications after male circumcision: Retrospective analysis of a German reference center] (German) 21 March 2014; Retrieved 24 November 2020.
- ↑
Patel H. The problem of routine circumcision. Canad Med Assoct J. 10 September 1966; 95(11): 576-81. PMID. PMC. Retrieved 25 November 2020.
- ↑ Williams N, Kapila L. Complications of circumcision.. Brit J Surg. 1993; 80(10): 1231-6. PMID. DOI. Retrieved 26 November 2020.
- ↑ Okeke L, Asinnobi A, Ikeurerowo O. Epidemiology of complications of male circumcision in Ibadan, Nigeria. BMC Urol.. 2006; 6(21) PMID. PMC. DOI. Retrieved 26 November 2020.
- ↑ Lau G, Kim J, Shaeffer A. Identification of circumcision complications using a regional claims database. Societies for Pediatric Urology. 2018; Retrieved 26 November 2020.
