Skip to main content
Top
Published in: BMC Urology 1/2016

Open Access 01-12-2016 | Research article

Circumcision-related tragedies seen in children at the Komfo Anokye Teaching Hospital, Kumasi, Ghana

Authors: Kwaku Addai Arhin Appiah, Christian Kofi Gyasi-Sarpong, Roland Azorliade, Ken Aboah, Dennis Odai Laryea, Kwaku Otu-Boateng, Kofi Baah-Nyamekye, Patrick Opoku Manu Maison, Douglas Arthur, Isaac Opoku Antwi, Benjamin Frimpong-Twumasi, Edwin Mwintiereh Yenli, Samuel Kodzo Togbe, George Amoah

Published in: BMC Urology | Issue 1/2016

Login to get access

Abstract

Background

Circumcision is a common minor surgical procedure and it is performed to a varying extent across countries and religions. Despite being a minor surgical procedure, major complications may result from it. In Ghana, although commonly practiced, circumcision-related injuries have not been well documented. This study is to describe the scope of circumcision-related injuries seen at the Komfo Anokye Teaching Hospital in Kumasi, Ghana.

Methods

The study was conducted at the Urology Unit of the Komfo Anokye Teaching Hospital in Kumasi. Consecutive cases of circumcision-related injuries seen at the unit over an 18 month period were identified and included in the study. Data was collected using a structured questionnaire. Data was entered and analysed using SPSS version 16. Charts and tables were generated using Microsoft Excel.

Results

A total of 72 cases of circumcision-related injuries were recorded during the 18 month period. Urethrocutaneous fistula was the commonest injury recorded, accounting for 77.8 % of cases. Other injuries recorded were glans amputations (6.9 %); iatrogenic hypospadias (5.6 %), and epidermal inclusion cysts (2.8 %). The majority of children were circumcised in health facilities (75 %) and nurses were the leading providers (77.8 %). The majority of circumcisions were conducted in the neonatal period (94.7 %).

Conclusion

Circumcision-related injuries commonly occurred in the neonatal period. Most of the injuries happened in health facilities. The most common injury recorded was urethrocutaneous fistula but the most tragic was penile amputation. There is the need for education and training of providers to minimise circumcision-related injuries in Ghana.
Literature
2.
go back to reference Krill AJ, Palmer LS, Palmer JS. Complications of circumcision. Sci World J. 2011;11:2458–68.CrossRef Krill AJ, Palmer LS, Palmer JS. Complications of circumcision. Sci World J. 2011;11:2458–68.CrossRef
4.
go back to reference Moslemi MK, Abedinzadeh M, Aghaali M. Evaluation of epidemiology, safety, and complications of male circumcision using conventional dissection surgery: experience at one center. Open Access J Urol. 2011;3:83–7.CrossRefPubMedPubMedCentral Moslemi MK, Abedinzadeh M, Aghaali M. Evaluation of epidemiology, safety, and complications of male circumcision using conventional dissection surgery: experience at one center. Open Access J Urol. 2011;3:83–7.CrossRefPubMedPubMedCentral
7.
8.
go back to reference Atikeler MK, Geçit I, Yüzgeç V, Yalçin O. Complications of circumcision performed within and outside the hospital. Int Urol Nephrol. 2005;37(1):97–9.CrossRefPubMed Atikeler MK, Geçit I, Yüzgeç V, Yalçin O. Complications of circumcision performed within and outside the hospital. Int Urol Nephrol. 2005;37(1):97–9.CrossRefPubMed
9.
go back to reference Hutcheson JC. Male neonatal circumcision: indications, controversies and complications. Urol Clin North Am. 2004;31(3):461–7. viii.CrossRefPubMed Hutcheson JC. Male neonatal circumcision: indications, controversies and complications. Urol Clin North Am. 2004;31(3):461–7. viii.CrossRefPubMed
10.
go back to reference Nelson CP, Dunn R, Wan J, Wei JT. The increasing incidence of newborn circumcision: data from the nationwide inpatient sample. J Urol. 2005;173(3):978–81.CrossRefPubMed Nelson CP, Dunn R, Wan J, Wei JT. The increasing incidence of newborn circumcision: data from the nationwide inpatient sample. J Urol. 2005;173(3):978–81.CrossRefPubMed
11.
go back to reference Ben Chaim J, Livne PM, Binyamini J, Hardak B, Ben-Meir D, Mor Y. Complications of circumcision in Israel: a one year multicenter survey. Isr Med Assoc J IMAJ. 2005;7(6):368–70.PubMed Ben Chaim J, Livne PM, Binyamini J, Hardak B, Ben-Meir D, Mor Y. Complications of circumcision in Israel: a one year multicenter survey. Isr Med Assoc J IMAJ. 2005;7(6):368–70.PubMed
13.
go back to reference Craig JC, Knight JF, Sureshkumar P, Mantz E, Roy LP. Effect of circumcision on incidence of urinary tract infection in preschool boys. J Pediatr. 1996;128(1):23–7.CrossRefPubMed Craig JC, Knight JF, Sureshkumar P, Mantz E, Roy LP. Effect of circumcision on incidence of urinary tract infection in preschool boys. J Pediatr. 1996;128(1):23–7.CrossRefPubMed
14.
go back to reference Crain EF, Gershel JC. Urinary tract infections in febrile infants younger than 8 weeks of age. Pediatrics. 1990;86(3):363–7.PubMed Crain EF, Gershel JC. Urinary tract infections in febrile infants younger than 8 weeks of age. Pediatrics. 1990;86(3):363–7.PubMed
15.
go back to reference Spach DH, Stapleton AE, Stamm WE. Lack of circumcision increases the risk of urinary tract infection in young men. JAMA. 1992;267(5):679–81.CrossRefPubMed Spach DH, Stapleton AE, Stamm WE. Lack of circumcision increases the risk of urinary tract infection in young men. JAMA. 1992;267(5):679–81.CrossRefPubMed
16.
go back to reference Wiswell TE, Geschke DW. Risks from circumcision during the first month of life compared with those for uncircumcised boys. Pediatrics. 1989;83(6):1011–5.PubMed Wiswell TE, Geschke DW. Risks from circumcision during the first month of life compared with those for uncircumcised boys. Pediatrics. 1989;83(6):1011–5.PubMed
17.
go back to reference Wiswell TE, Miller GM, Gelston HM, Jones SK, Clemmings AF. Effect of circumcision status on periurethral bacterial flora during the first year of life. J Pediatr. 1988;113(3):442–6.CrossRefPubMed Wiswell TE, Miller GM, Gelston HM, Jones SK, Clemmings AF. Effect of circumcision status on periurethral bacterial flora during the first year of life. J Pediatr. 1988;113(3):442–6.CrossRefPubMed
18.
go back to reference Bailey RC, Egesah O, Rosenberg S. Male circumcision for HIV prevention: a prospective study of complications in clinical and traditional settings in Bungoma, Kenya. Bull World Health Organ. 2008;86(9):669–77.CrossRefPubMedPubMedCentral Bailey RC, Egesah O, Rosenberg S. Male circumcision for HIV prevention: a prospective study of complications in clinical and traditional settings in Bungoma, Kenya. Bull World Health Organ. 2008;86(9):669–77.CrossRefPubMedPubMedCentral
19.
go back to reference Gray RH, Kigozi G, Serwadda D, Makumbi F, Watya S, Nalugoda F, et al. Male circumcision for HIV prevention in men in Rakai, Uganda: a randomised trial. Lancet. 2007;369(9562):657–66.CrossRefPubMed Gray RH, Kigozi G, Serwadda D, Makumbi F, Watya S, Nalugoda F, et al. Male circumcision for HIV prevention in men in Rakai, Uganda: a randomised trial. Lancet. 2007;369(9562):657–66.CrossRefPubMed
20.
go back to reference Millett GA, Flores SA, Marks G, Reed J, Herbst JH. Circumcision status and risk of hiv and sexually transmitted infections among men who have sex with men: a meta-analysis. JAMA. 2008;300(14):1674–84.CrossRefPubMed Millett GA, Flores SA, Marks G, Reed J, Herbst JH. Circumcision status and risk of hiv and sexually transmitted infections among men who have sex with men: a meta-analysis. JAMA. 2008;300(14):1674–84.CrossRefPubMed
21.
go back to reference Young MR, Odoyo-June E, Nordstrom SK, Irwin TE, Ongong’a DO, Ochomo B, et al. Factors associated with uptake of infant male circumcision for HIV prevention in western Kenya. Pediatrics. 2012;130(1):e175–82.CrossRefPubMed Young MR, Odoyo-June E, Nordstrom SK, Irwin TE, Ongong’a DO, Ochomo B, et al. Factors associated with uptake of infant male circumcision for HIV prevention in western Kenya. Pediatrics. 2012;130(1):e175–82.CrossRefPubMed
22.
go back to reference Kochen M, McCurdy S. Circumcision and the risk of cancer of the penis. A life-table analysis. Am J Dis Child 1960. 1980;134(5):484–6.CrossRef Kochen M, McCurdy S. Circumcision and the risk of cancer of the penis. A life-table analysis. Am J Dis Child 1960. 1980;134(5):484–6.CrossRef
23.
go back to reference Morris BJ, Gray RH, Castellsague X, Bosch FX, Halperin DT, Waskett JH, et al. The strong protective effect of circumcision against cancer of the penis. Adv Urol. 2011;2011, e812368.CrossRef Morris BJ, Gray RH, Castellsague X, Bosch FX, Halperin DT, Waskett JH, et al. The strong protective effect of circumcision against cancer of the penis. Adv Urol. 2011;2011, e812368.CrossRef
24.
go back to reference Schoen EJ. The relationship between circumcision and cancer of the penis. CA Cancer J Clin. 1991;41(5):306–9.CrossRefPubMed Schoen EJ. The relationship between circumcision and cancer of the penis. CA Cancer J Clin. 1991;41(5):306–9.CrossRefPubMed
25.
go back to reference Wilcken A, Keil T, Dick B. Traditional male circumcision in eastern and southern Africa: a systematic review of prevalence and complications. Bull World Health Organ. 2010;88(12):907–14.CrossRefPubMedPubMedCentral Wilcken A, Keil T, Dick B. Traditional male circumcision in eastern and southern Africa: a systematic review of prevalence and complications. Bull World Health Organ. 2010;88(12):907–14.CrossRefPubMedPubMedCentral
26.
go back to reference Afsari M, Beasley SW, Maoate K, Heckert K. Attitudes of pacific parents to circumcision of boys. Pac Health Dialog. 2002;9(1):29–33.PubMed Afsari M, Beasley SW, Maoate K, Heckert K. Attitudes of pacific parents to circumcision of boys. Pac Health Dialog. 2002;9(1):29–33.PubMed
27.
go back to reference Osarumwense DO, Ovueni EM. Current views, levels of acceptance, and practice of male circumcision in Africa subregion. Ann Pediatr Surg. 2009;5(4):254–60. Osarumwense DO, Ovueni EM. Current views, levels of acceptance, and practice of male circumcision in Africa subregion. Ann Pediatr Surg. 2009;5(4):254–60.
28.
go back to reference Elbakry A. Management of urethrocutaneous fistula after hypospadias repair: 10 years’ experience. BJU Int. 2001;88(6):590–5.CrossRefPubMed Elbakry A. Management of urethrocutaneous fistula after hypospadias repair: 10 years’ experience. BJU Int. 2001;88(6):590–5.CrossRefPubMed
29.
go back to reference Richter F, Pinto PA, Stock JA, Hanna MK. Management of recurrent urethral fistulas after hypospadias repair. Urology. 2003;61(2):448–51.CrossRefPubMed Richter F, Pinto PA, Stock JA, Hanna MK. Management of recurrent urethral fistulas after hypospadias repair. Urology. 2003;61(2):448–51.CrossRefPubMed
30.
go back to reference Ikuerowo SO, Bioku MJ, Omisanjo OA, Esho JO. Urethrocutaneous fistula complicating circumcision in children. Niger J Clin Pract. 2014;17(2):145–8.CrossRefPubMed Ikuerowo SO, Bioku MJ, Omisanjo OA, Esho JO. Urethrocutaneous fistula complicating circumcision in children. Niger J Clin Pract. 2014;17(2):145–8.CrossRefPubMed
31.
go back to reference Ceylan K, Burhan K, Yilmaz Y, Can S, Kuş A, Mustafa G. Severe complications of circumcision: an analysis of 48 cases. J Pediatr Urol. 2007;3(1):32–5.CrossRefPubMed Ceylan K, Burhan K, Yilmaz Y, Can S, Kuş A, Mustafa G. Severe complications of circumcision: an analysis of 48 cases. J Pediatr Urol. 2007;3(1):32–5.CrossRefPubMed
32.
go back to reference Kaplan GW. Complications of circumcision. Urol Clin North Am. 1983;10(3):543–9.PubMed Kaplan GW. Complications of circumcision. Urol Clin North Am. 1983;10(3):543–9.PubMed
33.
go back to reference Mazza ON, Cheliz GM. Glanuloplasty with scrotal flap for partial penectomy. J Urol. 2001;166(3):887–9.CrossRefPubMed Mazza ON, Cheliz GM. Glanuloplasty with scrotal flap for partial penectomy. J Urol. 2001;166(3):887–9.CrossRefPubMed
34.
go back to reference Shaeer O, El-Sebaie A. Construction of neoglans penis: a new sculpturing technique from rectus abdominis myofascial flap. J Sex Med. 2005;2(2):259–65.CrossRefPubMed Shaeer O, El-Sebaie A. Construction of neoglans penis: a new sculpturing technique from rectus abdominis myofascial flap. J Sex Med. 2005;2(2):259–65.CrossRefPubMed
35.
go back to reference Gluckman GR, Stoller ML, Jacobs MM, Kogan BA. Newborn penile glans amputation during circumcision and successful reattachment. J Urol. 1995;153(3 Pt 1):778–9.PubMed Gluckman GR, Stoller ML, Jacobs MM, Kogan BA. Newborn penile glans amputation during circumcision and successful reattachment. J Urol. 1995;153(3 Pt 1):778–9.PubMed
36.
go back to reference Essid A, Hamzaoui M, Sahli S, Houissa T. Glans reimplantation after circumcision accident. Prog En Urol J Assoc Fr Urol Société Fr Urol. 2005;15(4):745–7. Essid A, Hamzaoui M, Sahli S, Houissa T. Glans reimplantation after circumcision accident. Prog En Urol J Assoc Fr Urol Société Fr Urol. 2005;15(4):745–7.
37.
go back to reference Hamoudi A, Shier M. Late complications of childhood female genital mutilation. J Obstet Gynaecol Can JOGC J Obstétrique Gynécologie Can JOGC. 2010;32(6):587–9. Hamoudi A, Shier M. Late complications of childhood female genital mutilation. J Obstet Gynaecol Can JOGC J Obstétrique Gynécologie Can JOGC. 2010;32(6):587–9.
38.
go back to reference Naimer SA, Peleg R, Meidvidovski Y, Zvulunov A, Cohen AD, Vardy D. Office management of penile skin bridges with electrocautery. J Am Board Fam Pract Am Board Fam Pract. 2002;15(6):485–8. Naimer SA, Peleg R, Meidvidovski Y, Zvulunov A, Cohen AD, Vardy D. Office management of penile skin bridges with electrocautery. J Am Board Fam Pract Am Board Fam Pract. 2002;15(6):485–8.
39.
go back to reference Gee WF, Ansell JS. Neonatal circumcision: a ten-year overview: with comparison of the Gomco clamp and the Plastibell device. Pediatrics. 1976;58(6):824–7.PubMed Gee WF, Ansell JS. Neonatal circumcision: a ten-year overview: with comparison of the Gomco clamp and the Plastibell device. Pediatrics. 1976;58(6):824–7.PubMed
Metadata
Title
Circumcision-related tragedies seen in children at the Komfo Anokye Teaching Hospital, Kumasi, Ghana
Authors
Kwaku Addai Arhin Appiah
Christian Kofi Gyasi-Sarpong
Roland Azorliade
Ken Aboah
Dennis Odai Laryea
Kwaku Otu-Boateng
Kofi Baah-Nyamekye
Patrick Opoku Manu Maison
Douglas Arthur
Isaac Opoku Antwi
Benjamin Frimpong-Twumasi
Edwin Mwintiereh Yenli
Samuel Kodzo Togbe
George Amoah
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Urology / Issue 1/2016
Electronic ISSN: 1471-2490
DOI
https://doi.org/10.1186/s12894-016-0183-1

Other articles of this Issue 1/2016

BMC Urology 1/2016 Go to the issue