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Complications of circumcision.

In summary, there are multiple complications that can occur following circumcision, ranging from the insignificant to the tragic. Virtually all of these complications are preventable with only a modicum of care. Unfortunately, most such complications occur at the hands of inexperienced operators who are neither urologists nor surgeons. However, it usually will fall to the urologist to consult in the management of these complications and to repair such problems as they arise.

Anesthesia↗

[Urinary tract infection in childhood (author's transl)].

The urinary tract infection ranks fourth among children's disorders, coming after contagious diseases and infection of the respiratory and digestive organs. Half of the children who have urinary tract infections are in early infancy, and the remaining 50 per cent are divided almost uniformly among those between the ages of 2 and 14. In keeping with the underlying causes, our material can be broken down as follows: in a fourth of the cases the disorder was such as to require an operation; 8 per cent of the children showed a neurologically disturbed micturition; about 40 per cent had a genuine distal urethral stenosis, and another 25 per cent showed changes in the urethral orifice and in the external genitals.

Adolescent↗

[Penile horn].

Two cases of penile horn are reported. This infrequent condition appears usually after a surgical circumcision. One of the cases presented with generalized metastasis. The nosology, prognosis and treatment of this entity is discussed.

Carcinoma, Squamous Cell↗

[Carcinoma of the penis: review of our cases].

A review is made of 36 carcinomas of the penis treated in the Urology Department of the "La Fe" Hospital. The most frequent decade for their appearance is the fifties. We establish their link with restricted hygiene and with fimosis, Queyrat's erythroplasia, leukoplasia and accuminated condyloma. The treatment given depends essentially on the clinical stage. We feel that within stage A, with minimum prepuce lesions, the ideal treatment is local excision and circumcision plus radiotherapy; in the case of minimal gland lesions radiotherapy; in the rest and when the former forms of therapy fail, partial amputation of the penis. We currently treat this stage with cryosurgery although we cannot give any results because of the limited period of development of the same. In stage B, we indicate amputation plus bilateral, ilio-inguinal lymphadenectomy plus radiotherapy. In stages C and D the treatment is palliative, on the basis of polychemotherapy.

Adult↗

Benefits and risks of circumcision.

Circumcisions are performed either prophylactically in the neonatal period or therapeutically at a later age. About 10% of males not circumcised at birth will eventually require circumcision. The present neonatal circumcision rate is about 80% in the United States and 40% in Canada. The single most important determinant of whether a newborn male will be circumcised is the attitude of the attending physician. The literature was reviewed to determine the proven benefits of circumcision and to compare these with the known risks. Circumcising the newborn facilitates penile hygiene, prevents cancer of the penis and decreases the incidence of genital herpes in later life. Whether it decreases the incidence of cancer of the cervix is still uncertain. More important, neonatal circumcision is associated with much lower morbidity and mortality and with lower costs than therapeutic circumcision. Thus, prophylactic circumcision is recommended for the male population as a whole.

Adolescent↗