This article refers to complications in connection with genital mutilation. The text is adapted from the (German) DocCheck Flexikon.
|“||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
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".
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.
- 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. These are:
- Extensive penile skin defects / avulsion
- Infection (minor and major)
- Penile herpes simplex virus type 1 infection (after Jewish ritual circumcision)
- Partial penile/glans amputation
- Complete penile amputation
- Penile haematoma
- Bleeding in the context of a genetic condition: haemophilia, sickle cell trait and factor VII deficiency
- Phimosis (referring to pathological phimosis)
- Sudden infant death syndrome
- Haemorrhage (bleeding) (outside of a genetic deficiency)
- Nonhealing wound
- Scrotal injuries
- Preputial stenosis
- Meatal stenosis
- Trapped/buried/concealed/inconspicuous penis
- Urethrocutaneous fistula
- Iatrogenic hypospadias
- Intraperitoneal bladder perforation (leading to life-threatening renal failure)
- Circulatory shock
- Death (from bleeding or infection)
- Unsatisfactory cosmetic results including uncircumcised appearance
- Device displacement
- Early sloughing of foreskin tissue
- Long foreskin obstructing urine flow
- Insufficient foreskin removal/redundant foreskin
- (Acute) Ischaemia (which can lead to necrosis)
- Skin bridges (penile skin adhesion)
- Fournier’s gangrene
- Penile mycosis leading to penile gangrene
- Glandular adhesion (of remnant foreskin)
- Implantation dermoid/epidermal inclusion cysts/penile implantation cyst
- Myiasis (fly infestation)
- Denuded penis
- Suture sinus tracts
- Lower clinical neurophysiological elicitability of the penilo-cavernosus reflex
- Sexual dysfunction
- Traumatic neuroma
- Decreased urine output
- Excessive skin removal
- Injury to urethra
- 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 the 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.
- (22 February 2013).
Complications of circumcision, CIRP.org. Retrieved 25 November 2020.
- Complications of Circumcision , Doctors Opposing Circumcision (D.O.C.). (July 2016). Retrieved 13 January 2022.
- Fahmy M (2009): Complications in Male Circumcision. 193 pages. ISBN 978-0-323-68127-8. Retrieved 16 March 2022.
Komplikation[Complication] (German). Retrieved 24 November 2020.
- Iacob SI, Feinn RS, Sardi L. Systematic review of complications arising from male circumcision . BJUI Compass. 11 November 2021; : 1–25. DOI. Retrieved 4 January 2022.
- (1 September 2017).
Drs. May Ask If Baby Is Circumcised for a Hearing Test - Here's Why, Joseph4GI. Retrieved 22 April 2022.