Secondary phimosis after circumcision

Özet

Objective: Male circumcision is one of the most common surgical procedures worldwide. Although it iswidely performed because of health issues, in Muslim-majority countries, the primary motivation yieldingto male circumcision is religious. It is a relatively safe procedure with a low overall complication rate. Weherein report an underrated complication of circumcision that can be termed as “secondary phimosis.”Material and methods: The medical records of 25 boys with post-circumcision secondary phimosis werereviewed. Demographics of the patients, method of circumcision, type of provider, peroperative findings andcomorbidities were recorded.Results: Between January 2005 and December 2016, 25 boys with post-circumcision secondary phimosiswere treated surgically. The median age of the patients was 3 (2-5) years. The majority of the patients werecircumcised by the Gomco clamp or Plastibell method (n=16). Of the patients’ circumcisions, six were performed by the freehand method, and three by the dorsal slit method. In 15 boys, circumcision was performedby a traditional provider. Of the boys, seven were circumcised by a physician, and three were circumcised bya pediatric surgeon. All the patients were re-circumcised. The common peroperative finding was the redundant mucosal inner layer of the prepucium. Excess suprapubic fat was present in 12 patients.Conclusion: Although circumcision is known as a minor surgical practice with low complication rate, itmust be performed safely and especially by experienced physicians/surgeons. Secondary phimosis is a technical error that is caused by insufficient removal of the inner mucosal layer of the prepucium. Re-circumcision of the patient is inevitable, causing the patient second trauma.