Circumcision Complications Rate Clarified

Male circumcision complications occurred at higher rate among adults than among infants

(RxWiki News) Male circumcision is currently regarded as a procedure that parents can choose for their sons but which is not routinely recommended by the American Academy of Pediatrics.

A recent study aimed to clarify the rate of complications that can occur with the procedure and found the rate to be less than 0.5 percent.

The risk of complications for adults, however, was much greater than the risk for infants. Boys aged 1 to 9 had the greatest risk for complications associated with circumcision.

"Discuss the risks and benefits of circumcision with your doctor."

The study, led by Charbel El Bcheraoui, PhD, of the US Centers for Disease Control and Prevention in Atlanta, looked at how commonly complications occur with male circumcision.

The researchers first came up with a list of 41 different adverse events ranging from minor to serious that could occur following a male circumcision, based on reviewing the medical literature.

Adverse events include any event that occurs following a male circumcision, even if it was not caused by the procedure.

The researchers determined it was probably that 16 of the adverse events, or 39 percent of them, were a result of the circumcision.

Then they analyzed the rate of these adverse events in an insurance claims data set called SDI Health, spanning 2001 to 2010 and including information from 1.4 million circumcisions.

Among the circumcision procedures recorded in the database, 93 percent of them were performed on newborn males.

The rate of adverse events following male circumcisions, calculated from this data set, was just under 0.5 percent.

The rate of potentially serious complications included a broad range depending on what the complication was.

For stricture of the male genital organs, in which the urethra become abnormally narrowed, the rate of complications was 0.76 occurrences per 1 million circumcisions.

Meanwhile, complications requiring repair of an incomplete circumcision occurred at a rate of 703 occurrences per 1 million circumcisions.

The rate of complications involving circumcisions among boys younger than 1 year old was considerably lower than the rate for older males.

For boys circumcised between the ages of 1 and 9, the rate of complications was approximately 20 times greater than the rate when a boy was an infant.

The rate of complications for males aged 10 and older was about 10 times greater than the rate for infants.

"Given the current debate about whether male circumcision should be delayed from infancy to adulthood for autonomy reasons, our results are timely and can help physicians counsel parents about circumcising their sons," the researchers wrote.

Tom Seman, MD, a pediatrician at North Shore Pediatrics in Danvers, Mass. agreed that these findings will be particularly helpful for parents.

"There are some things that are meant to be done as an infant, some as a child and some things that we are meant to have done as an adult," he said. "Circumcision is definitely a procedure to have done as an infant. This is a great article to have at or disposal when discussing with parents who are considering waiting yet expect that their son will have the procedure done."

However, this findings will not change the fact that circumcision will remain quite controversial, he noted.

"Except for religious reasons and the increased risk of penile cancer in African countries, albeit low, there is no reason for a male to be circumcised," Dr. Seman said.

"It has been heavily adopted in the United States and now is considered a routine procedure," he said. "The procedure itself is very simple, and a newborn infant's body seems ready to quickly heal a cut or break in the skin," so the study's findings are not surprising, he added.

"The only complications I have ever seen with circumcisions is when there was a previously undiagnosed bleeding disorder and the child had continued bleeding at the incision site," Dr. Seman said. "This can then be corrected. As for any other complications, in my 22 years I have seen none."

The study was published May 12 in the journal JAMA Pediatrics. The research was funded by the US Centers for Disease Control and Prevention. The authors reported no conflicts of interest.

Review Date: 
May 11, 2014