Siroosbakht Soheila, Rezakhaniha Bijan
Department of Pediatrics, Golestan Hospital AJA University of Medical Sciences Tehran Iran.
Department of Urology, Imam Reza Hospital AJA University of Medical Sciences Tehran Iran.
Health Sci Rep. 2022 Nov 21;5(6):e939. doi: 10.1002/hsr2.939. eCollection 2022 Nov.
Major circumcision complications are rare; however, circumcision arouses distress in some special cases. The present study aimed to compare infancy and childhood regarding the frequency and relative risk of early and late complications of circumcision.
This study was a retrospective cohort data analysis including 240 neonates and 240 children referred for circumcision from 2015 to 2021. All circumcisions were performed using the surgical dorsal-ventral slits method. A Cox proportional hazard model was used to assess the relative risk (RR) of complications at a confidence Interval of 95%.
The mean age was 19.32 ± 6.5 days for the neonates and 46.1 ± 8.8 months for the children. In general, complications occurred in 61 boys (12.7%), 40 neonates (8.3%), and 21 children (4.4%) (˂0.001). Bleeding was the most common early complication in six neonates (2.5%) and three children (1.3%), and meatal stenosis was the most common late complication in 10 neonates (4.2%) and four children (1.6%). Meatal web was observed in 11 neonates (4.6%) and four children (1.6%), and the incomplete removal of the prepuce, as "not very satisfactory", was also noticed in nine neonates (3.75%) and three children (1.3%). The circumcision complications were significantly more frequent in neonates than in children (RR = 2.6, 95% CI 1.46-4.71, <0.001). The neonatal circumcisions had a significant risk of the incomplete removal of the prepuce, meatal web, and meatal stenosis compared to children (RR = 3, 95% CI 5.83-10.81, <0.04; RR = 2.75, 95% CI 0.9-8.3, ˂0.03; RR = 2.5, 95% CI 0.8-7.75, <0.04, respectively).
The risk of complications is higher in neonates than children. The incomplete removal of prepuce, meatal web, and meatal stenosis are significantly higher in neonates than in children. Before prohibiting or recommending this procedure, practitioners should provide comprehensive information about its risks and benefits. Parents should weigh up the risks and benefits and make the best decision regarding their personal beliefs and customs.
包皮环切术的主要并发症较为罕见；然而，在某些特殊情况下，包皮环切术会引起困扰。本研究旨在比较婴儿期和儿童期包皮环切术早期和晚期并发症的发生率及相对风险。
本研究为回顾性队列数据分析，纳入了2015年至2021年因包皮环切术前来就诊的240例新生儿和240例儿童。所有包皮环切术均采用手术背腹切开法。使用Cox比例风险模型评估并发症在95%置信区间的相对风险（RR）。
新生儿的平均年龄为19.32±6.5天，儿童的平均年龄为46.1±8.8个月。总体而言，61名男孩（12.7%）出现并发症，其中40例新生儿（8.3%），21例儿童（4.4%）（<0.001）。出血是最常见的早期并发症，6例新生儿（2.5%）和3例儿童（1.3%）出现该并发症，尿道口狭窄是最常见的晚期并发症，10例新生儿（4.2%）和4例儿童（1.6%）出现该并发症。11例新生儿（4.6%）和4例儿童（1.6%）观察到尿道口蹼，9例新生儿（3.75%）和3例儿童（1.3%）的包皮切除不完全，“不太满意”。新生儿包皮环切术并发症的发生率显著高于儿童（RR = 2.6，95% CI 1.46 - 4.71，<0.001）。与儿童相比，新生儿包皮环切术出现包皮切除不完全、尿道口蹼和尿道口狭窄的风险显著更高（RR分别为3，95% CI 5.83 - 10.81，<0.04；RR为2.75，95% CI 0.9 - 8.3，<0.03；RR为2.5，95% CI 0.8 - 7.75，<0.04）。
新生儿并发症的风险高于儿童。新生儿包皮切除不完全、尿道口蹼和尿道口狭窄的发生率显著高于儿童。在禁止或推荐该手术之前，从业者应提供有关其风险和益处的全面信息。家长应权衡风险和益处，并根据个人信仰和习俗做出最佳决定。
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