Complication

From IntactiWiki
Jump to navigation Jump to search

This article refers to complications in connection with genital mutilation. The text is adapted from the (German) DocCheck Flexikon.[1]

Although haemorrhage and sepsis are the main causes of morbidity, the variety of complications is enormous. The literature abounds with reports of morbidity and even death as a result of circumcision.
– Neville Williams & Leela Kapila

Definition

In medicine, a complication is the undesired development or the unexpectedly difficult course of a disease, trauma or therapy. Complications are therefore secondary events.

In relation to drug therapy, the term "side effect" is used rather than "complication".

Background

Complications of a disease can arise from many different mechanisms, for example through

  • spread of inflammatory processes (e.g. septicemia in an abscess);
  • bleeding complications (e.g. with anticoagulation);
  • dysregulation (e.g. shock);
  • chronic tissue damage (e.g. neuropathy in diabetes mellitus).

In the case of invasive interventions in the human body, complications are frequent and must be communicated to the patient as part of the patient education. A "circumcision" is an invasive intervention in the human body by definition.

Classification

  • Early complication: Short time between the triggering event and the occurrence of the complication
  • Late complication: Long time lag between the triggering event and the occurrence of the complication

47 classes of complications

In a recently published meta-study, Iacob et al. (2021) defined 47 classes of complications arising from male circumcision.[2] These are:

  1. Extensive penile skin defects / avulsion
  2. Infection (minor and major)
  3. Penile herpes simplex virus type 1 infection (after Jewish ritual circumcision)
  4. Necrosis
  5. Partial penile/glans amputation
  6. Complete penile amputation
  7. Penile haematoma
  8. Bleeding in the context of a genetic condition: haemophilia, sickle cell trait and factor VII deficiency
  9. Oedema
  10. Keloids
  11. Phimosis (referring to pathological phimosis)
  12. Sudden infant death syndrome
  13. Haemorrhage (bleeding) (outside of a genetic deficiency)
  14. Nonhealing wound
  15. Scrotal injuries
  16. Preputial stenosis
  17. Meatal stenosis
  18. Cicatrix
  19. Meatitis
  20. Trapped/buried/concealed/inconspicuous penis
  21. Urethrocutaneous fistula
  22. Iatrogenic hypospadias
  23. Intraperitoneal bladder perforation (leading to life-threatening renal failure)
  24. Circulatory shock
  25. Death (from bleeding or infection)
  26. Unsatisfactory cosmetic results including uncircumcised appearance
  27. Device displacement
  28. Early sloughing of foreskin tissue
  29. Long foreskin obstructing urine flow
  30. Insufficient foreskin removal/redundant foreskin
  31. (Acute) Ischaemia (which can lead to necrosis)
  32. Pain
  33. Skin bridges (penile skin adhesion)
  34. Fournier’s gangrene
  35. Penile mycosis leading to penile gangrene
  36. Glandular adhesion (of remnant foreskin)
  37. Implantation dermoid/epidermal inclusion cysts/penile implantation cyst
  38. Myiasis (fly infestation)
  39. Denuded penis
  40. Chordee
  41. Suture sinus tracts
  42. Lower clinical neurophysiological elicitability of the penilo-cavernosus reflex
  43. Sexual dysfunction
  44. Traumatic neuroma
  45. Decreased urine output
  46. Excessive skin removal
  47. Injury to urethra

Other complications

  • Rupture of the ear drum: The website Saving Our Sons (SoS) reported in 2017 about a hearing test for a boy where the doctor asked if they boy was circumcised. After being asked if that was a relevant question, the doctor stated that sometimes an ear drum can burst while they are crying during the circumcision.[3]

See also

External links

References

  1. REFweb Komplikation [Complication] (German). Retrieved 24 November 2020.
  2. REFjournal Iacob SI, Feinn RS, Sardi L. Systematic review of complications arising from male circumcision PDF. BJUI Compass. 11 November 2021; : 1–25. Retrieved 4 January 2022.
  3. REFweb (1 September 2017). Drs. May Ask If Baby Is Circumcised for a Hearing Test - Here's Why, Joseph4GI. Retrieved 22 April 2022.