Introduction: Circumcision is widely accepted for newborns in the United States. However, circumcision carries a risk of complication, the rates of which are not well described. Methods: Retrospective longitudinal analysis... [ view full abstract ]
Introduction: Circumcision is widely accepted for newborns in the United States. However, circumcision carries a risk of complication, the rates of which are not well described.
Methods: Retrospective longitudinal analysis of the California Office of Statewide Health Planning and Development patient discharge database (OSHPD) was performed for the years 2005 to 2010. Circumcised patients under the age 5 years were analysed. Using ICD-9 and CPT codes, we abstracted immediate and 5-year overall complications. Multivariate regression was performed to determine the risk of immediate complications, adjusting for the demographics of the patients.
Results: A total of 24,305 children were analysed. Immediate complication rates were 1.5%, with 1.1 % requiring surgical repair while the additional 0.4% had haemorrhage or infection that did not require repeat surgery. 5- year complication rate was 4.1%, with 5-year re-operation rate of 3.9%. 5-year complications were higher in non-neonates than neonates (4.1% and 1.5% respectively), in outpatients than in-patients (3.9% and 1.6% respectively) and varied with different insurance types (all p<0.001). On adjusted analysis, non-neonates (OR 7.96) and inpatient (OR 2.04) circumcision had significantly higher risks of 5-year complications. (all p<0.001).
Conclusions: The complication rate for male circumcision is 4.1% and is higher than previously reported. The majority of these patients require a second operation. Clinicians should include a discussion of these risks when counselling parents about circumcision.
