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Table 2 Retrospective studies of frequency of complications in studies of neonatal and infant circumcision

From: Complications of circumcision in male neonates, infants and children: a systematic review

Author

Country

Year of study

Number of patients

Age

Type of provider

Method used

Frequency of adverse eventsa

Frequency of serious adverse eventsb

Al-Marhoon [34]

Oman

1997-2000

171

Neonatal

Surgeon

Plastibell

1.2%c

0%

(Two needed sutures)

Christakis [35]

USA

1987-1996

130475

Neonatal

-

-

0.2%

0.2%

Eroglu [41]

Turkey

2001-2002

214

Neonatal

Surgeon

Gomco clamp

2.3%

0%

(One needed sutures)

Gee [38]

USA

1963-1972

5521

Neonatal

Supervised medical student, resident, or physician

52% Gomco clamp

48% Plastibell

1.7% Gomco

2.3% Plastibell

0.2%d

Iftikhar [36]

Pakistan

1998-2001

316

0-12 yrs (72% within 1 week of birth)

Pediatric surgeon

Plastibell (<2 yrs old)

Open technique (≥ 2 yrs)

0.6%

0%

Metcalf [42]

USA

1974-1979

591

61% Neonatal

39% Post-neonatal

-

-

4% neonatal

10%% infantse

0.3% neonatal

1.3% infants

O'Brien [39]

USA

1985-1986

1951

Neonatal

-

43% Gomco

9.5% Plastibell

14.5% Electrocautary

33% not specified

3.1% overall

0%

Rafiq [40]

Pakistan

2000

100

Neonatal

Surgeon

Plastibell

2%

0%

Shulman [37]

Israel

1955-1963

8000

Neonatal

Mohelim

-

0.3%

0.1%

Wiswell [19]

USA

1980-1985

100157

Neonatal

Surgeons

 

0.2% 'serious'

0.2%

  1. a Cases of minor bleeding stopped with simple pressure or 'conservative management' and excessive foreskin/inadequate circumcision are not included
  2. b Includes complications defined as 'serious' or 'severe' by authors, or with long-term or life-threatening sequalae (partial amputation of glans, urethral laceration, need for re-surgery or plastic surgery)
  3. c Excludes one patient unable to pass urine for 24 hours
  4. d The authors note that 14 patients (0.2%) had 'really significant' complications - one life-threatening haemorrhage, 4 systemic infections, 8 circumcisions of infants with hypospaidas, and one complete denudation of the penile shaft.
  5. e 6 patients with hygiene concerns were excluded