PURPOSE

To compare the rate and types of complications in boys who underwent partial and total circumcision for pathological phimosis. 

MATERIAL AND METHODS

We retrospectively reviewed the records of patients under 18 years of age operated for phimosis from 2009 to 2012. Out of 347 patients included in the analysis, 273 underwent partial (group P) and 74 total (group T) circumcision. The complications were divided into short-term (within the first month), long-term, mild and severe with the need of re-operation.

RESULTS

The age distribution in groups P and T was similar with the mean 6.5 and 5.7 years, respectively. The short-term complication rate was significantly higher in P compared to group T (23 to 11%, p-value 0.02) and also higher in the long-term (22 to 9%, p-value 0.013), making the overall complication rate 36 to 19%, p-value 0.005. Of all the complications 97% were mild (painful swelling, scarring, adhesions, infection and haemorrhage). They all resolved during the follow-up 0.2 to 47.3 months (the mean 2.7 months). 3% were severe, all in group P (scarring 8x, paraphimosis 2x, poor cosmesis 1x).

CONCLUSIONS

Partial circumcision (excision of the distal fibrotic ring) is preferred due to cultural habits in our country. The boys and their parents should be warned about the high rate of expected complications that is the double compared to total circumcision.

Source: European Society of Paediatric Urology (ESPU) 2016 Harrogate, Yorkshire UK

Reported by Motol University Hospital, Charles University in Prague, Paediatric Surgery, Prague, CZECH REPUBLIC dated 23 June 2016

Comment by Dr Khan:  Partial circumcision has a high rate of expected complications that is the double compared to full circumcision according to this report