Penile Injury During Ritual Circumcision

Abstract

Purpose: Circumcision is one of the most prevalently performed surgeries worldwide. It is a common non-therapeutic procedure, which, based on the cultural and social background of people, could be performed by individuals at different levels of skill ranging from trained medical professionals to non-specialists. Therefore, this surgery could cause complications of varying frequencies and types. For example, penile damage during the circumcision procedure is a severe and rare complication leaving patients with morbidity and life-long consequences. Here, we reported two cases of penile injury during a ritual circumcision. Patients and Methods: This study was approved by the ethics committee of Ibb University of Medical Sciences. Case 1: A 6-month-old child was brought to hospital by parents with complaints of purulent discharge around the penis after ritual circumcision performed 3 days ago with complete skin loss in the whole part of the penis extended to the scrotum and suprapubic area. Case 2: A 2-month-old child was brought to hospital with complaints of penile discharge and gangrene after ritual circumcision performed 10 days ago. Results: Case 1: He was treated with daily debridement and wound irrigation followed by a surgical procedure to bury the penis in the scrotum for future reconstructive surgery. Case 2: A suprapubic cystostomy was inserted into the bladder. Then, daily debridement and wound irrigation was performed for the child. To treat penile gangrene, two options were available. The first option was to bury the penis in the scrotum and do reconstructive surgery later. The second option was to change the child’s anatomical sex from male to female. Conclusion: We suggest that every child, before a circumcision procedure, should be evaluated by a medically trained professional. This procedure should also be carried out in aseptic conditions. Additionally, the circumcision procedure needs to be performed by an experienced medical professional.