Burden of Delayed Circumcision on Healthcare Systems: a Retrospective Study.

Background: Circumcision is a surgical procedure that is performed for a variety of cultural, medical, and religious purposes. Carbonic Circumcision is a surgical procedure which has the potential to be performed in a public health setting and offers several advantages particularly in the prevention of disease.

Objective: This study aims to evaluate the financial, medical, and sociodemographic impacts of delayed circumcision as compared to early circumcision.

Methods: This retrospective study was carried after obtaining IRB approval from our institution (IRB-2024-01-814). Records of circumcision cases from January 2020 to January 2024 were reviewed comparing early circumcisions (within the first 90 days of life) done under local anesthesia with delayed circumcisions (after 180 days of life) done under general anesthesia.

Results: A total of 192 patients were excluded due to various reasons: Hypospadias (57 cases), ambiguous genitalia with bilateral undescended testes (26 cases), penile web (22 cases), buried penis (12 cases), penoscrotal transposition (4 cases), and other systemic abnormalities (7 cases). Studies have shown multiple long term economic benefits when circumcision is done early on in life. The cost of circumcision performed later in life is relatively higher than that performed early. In older children, circumcision requires general anesthesia, hospital bed utilization and post operative care which significantly increases the direct cost of the procedure compared to a procedure that is done in an outpatient setting under local anesthesia.

Conclusion: Delayed circumcision translates into expedited healthcare costs while circumcising neonates fosters more overall affordable and less risky surgery. Appropriate measures should be taken from the side of the decision makers in order to endorse neonatal circumcision practices during such interventions where there is a disparity in healthcare equity, costs or patient outcomes..