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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