Necrosis

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Necrosis means [d]eath of cells through injury or disease, especially in a localized area of a tissue or organ.[1]

The Plastibell, Prepex, and TARA KLamp circumcision devices intentionally cause necrosis of the foreskin by ischaemia, which causes the foreskin to die and fall off.

Necrosis is a complication of circumcision. Rosemary Romberg (2021) reported necrosis of the glans due to overly tight bandage or a Plastibell ring that was too small.[2]

Therapy

Tasci et al. (2020) surveyed the medico-legal aspects of post-circumcision necrosis. Information on 24 cases was collected. The patients were treated for necrosis by surgical intervention in 15 (62.5%) patients, hyperbaric oxygen treatment (HBOT) in 6 (25%), the conservative approach in 2 (8.3%), and HBOT plus surgical intervention in 1 (4.1%) patient.[3]

Case reports

Sterenberg et al. (1981) reported a case of necrosis of the glans penis after ritual circumcision of a ten-day-old boy by a mohel. The boy had a blackened glans penis. He was hospitalized but the necrotic glans penis fell off.[4]

Barnes et al. (2006) reported the case of a two-week-old male infant who developed glans necrosis after a non-therapeutic circumcision. The boy is reported to have suffered only cosmetic damage with no functional impairment expected.[5]

Aminsharifi et al. (2013) reported two cases of glans necrosis after circumcision.[6]

References

  1. REFweb (2007). Necrosis, The Free Dictionary. Retrieved 19 January 2022.
  2. REFbook Romberg, Rosemary (2021): Glans Necrosis, in: Circumcision — The Painful Dilemma. Ulf Dunkel (ed.). Edition: Second Edition, Revised. Kindle. P. 278. ISBN 23: 979-8683021252. Retrieved 31 August 2023.
  3. REFjournal Tasci AI, Danacioglu YO, Arikan Y, et al. Management of post-circumcision necrosis of the penis: the medicolegal aspect. Pediatr Surg Int. April 2020; 36(4): 523-8. PMID. DOI. Retrieved 20 January 2022.
  4. REFjournal Sterberg N, Golan J, Ben-Hur N. Necrosis of the Glans Penis Following Neonatal Circumcision. Plast Reconstr Surg. August 1981; 68(2): 237-9. PMID. DOI. Retrieved 10 January 2022.
  5. REFjournal Barnes, Sophie, Ben Chaim, Jacob, Kessler, Ada. Postcircumcision necrosis of the glans penis: Gray-scale and color doppler sonographic findings. J Clin Ultrasound. February 2007; 35(2): 105-7. PMID. DOI. Retrieved 20 January 2022.
  6. REFjournal Aminsharifi A, Afsar F, Tourchi A. Delayed Glans Necrosis after Circumcision: Role of Testosterone in Salvaging Glans. The Indian Journal of Pediatrics. September 2013; 80(9): 791-3. PMID. DOI. Retrieved 19 January 2022.