Severe Wound Infection and Complications Following Traditional Male Circumcision in Rural Somalia: A Case Report of Malpractice in a Resource-Limited Setting.

Abstract

Introduction: Traditional male circumcision (TMC) is a common cultural and religious practice in Somalia. However, procedures performed by untrained practitioners under non sterile conditions can result in severe complications. This case report describes the delayed presentation and successful management of a 6-year-old boy who experienced wound infection and complications following a traditional circumcision.

Case presentation: A 6-year-old boy from Shaan Town, Middle Shabelle region, Somalia, presented with urinary retention, lower abdominal pain, and penile discharge 15 days after traditional circumcision performed using non-sterile equipment. Initially, he experienced painful urinary dribbling progressing to complete urinary retention, accompanied by local infection characterized by swelling, redness, and foul-smelling discharge. Despite oral antibiotics administered at home, his condition deteriorated, prompting hospital admission near Mogadishu, where intravenous antibiotics and catheterization were initiated. Due to worsening symptoms, the patient was referred to our tertiary facility, where surgical debridement and primary closure of necrotic circumcision tissue were successfully performed. Postoperative recovery was uneventful, with complete normalization of urinary function and resolution of infection. Follow-up examinations at two weeks and one month confirmed satisfactory healing without residual complications.

Conclusion: This case underscores the significant risks of traditional circumcision performed by untrained practitioners, emphasizing the need for public health interventions. This report highlights the importance of integrating safe medical practices into cultural frameworks to improve outcomes in resource-limited settings.