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

Weiss, Helen A; Larke, Natasha; Halperin, Daniel; Schenker, Inon

doi:10.1186/1471-2490-10-2

BMC Urology

Table 6 Frequency of complications in studies of adolescent and adult circumcision

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

Author	Country	Years	Setting	N	Age	Provider	Method	Indication	Follow-up period	Frequency of adverse events^a	Frequency of serious adverse events^b
Auvert [14]	South Africa	2002-2004	GP offices	1495 HIV neg	18-24 years	GPs	Forceps guided	Enrolled in trial	1 month	3.6%	-
Auvert [14]	South Africa	2002-2004	GP offices	73 HIV positive	18-24 years	GPs	Forceps guided	Enrolled in trial	1 month	8.2%	-
Bailey [60]	Kenya	2004	Home or community	445	66% aged below 15 years	Traditional	-	Cultural	30-89 days	35%	24%^c
Bailey [60]	Kenya	2004	Home or community	12		Traditional	-	Cultural	~3 months	83%	33%^d
Bailey [60]	Kenya	2004	Hospital, health centre, or private office	562	90% aged below 15 years	Clinician^e	-	Cultural	30-89 days	18%^f	19%^h
Bailey [60]	Kenya	2004	Hospital, health centre, or private office	12	-	Clinician^j	-	Cultural	~3 months	92%^e	25%ⁱ
Bowa [78]	Zambia	2004-2006	Urology outpatient clinic	900	5 months to 96 years	Trained clinical officer	Dorsal slit method	Cultural	8 weeks	3.0%	0.06% at 8 weeks
Kigozi [62]	Uganda	2003-2005	Trial operating theatre	2326 HIV neg	15-49 years	Trained physician	Sleeve method/	Enrolled in trial	6 weeks	7.4%	0.2% severe 3.3% moderate
Kigozi [62]	Uganda	2003-2006	Trial operating theatre	420 HIV positive	15-49 years	Trained physician	Sleeve method/	Enrolled in trial	6 weeks	6.0%	0% severe (3.1% moderate)
Krieger[61]	Kenya	2002-2005	Trial clinic	1475	18-24 years	Medical and clinical officers	Forceps guided	Enrolled in trial	90 days	1.8%	0% severe (0.7% moderate)
Magoha [79]	Nigeria & Kenya	1981-1998	Hospital	249	32% neonates 6% children 61% adolescent/adult	Surgeon	Forceps guided	72% Cultural/religious 12% Parental request 16% Medical	-	11%	2.8% severe^g
Peltzer[80]	South Africa			78	Median 19 years (range 16-25)	Doctors and nurses following 1 day training		Cultural (Xhosa initiat	-	3.8%	0%

^a Cases of minor bleeding stopped with simple pressure or 'conservative management' and excessive foreskin/inadequate circumcision are not included
^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)
^c Wound not healed at 60 days after surgery
^d Permanent adverse sequale
^e Anyone considered by the participant to be a clinician
^f Including an unknown number with residual foreskin
^g Includes severe haemorrhage (n = 3), scrotal laceration (n = 2), penile shaft denudation (n = 1) and glandular injury (n = 1).

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ISSN: 1471-2490

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