APRIL 2024
Practice of performing male circumcisions on young infants, evaluation of several common surgical procedures and drawing attention to circumcision errors
1Hadi Raza, 2Abdul Basit, 3Ali Raza, 4Mohib Ali, 5Mobeen Ali, 6Umar Khan
PIMS, Children’s Hospital Lahore and Government Mian Meer hospital Lahore, PIMS, PIMS, PIMS, PIMS
Correspondence: Hadi Raza, PIMS
Abstract
BACKGROUND: Male circumcision is one of the oldest procedures done worldwide and is an encouraged practice in Muslim culture. In Pakistan, all men are circumcised for religious reasons. It may be done using a variety of approaches, including suture less procedures, device methods, and traditional open methods.
OBJECTIVE: This study’s goals were to describe our practice of performing male circumcisions on young infants, evaluate several common surgical procedures, and draw attention to circumcision errors committed by quacks in Pakistan.
MATERIALS: A comparative observational research was carried out at Children’s Hospital Lahore and duration of study is 2019 – 2022. When a child arrived for a primary circumcision, one of two surgical methods—the dorsal slit method or the Guillotine method—was used. The research also included a prospective review of children treated for circumcision errors by non-professionals. Delayed circumcisions were those performed after the age of two. The analysis of the data was performed using SPSS version 26.
RESULTS: Over a five-year period, 689 Muslim male children in Pakistan, ranging in age from 1 day to 10 years, were examined. The research comprised 655 children for primary circumcision and 34 children treated for circumcision errors. The majority of children (33.28%) who had primary circumcision were between the ages of 1 and 2 years old. 201 (94.81%) of infants delivered at home and 114 (25.73%) of babies born in hospitals had delayed circumcision, which occurs after the age of two (p-value = 0.00001). The sole justification for circumcision in this research was a religious one. Using computer-generated random numbers, 396 (60.46%) and 259 (39.54%) children were circumcised using the dorsal slit and guillotine methods, respectively. In the dorsal slit procedure, complications were discovered in 8.08% of participants, compared to 16.60% in the guillotine technique (p-value = 0.008). Out of 34 infants treated for circumcision errors, 11 (32.35%) had excessive bleeding after primary circumcision by half physicians, 18 (52.94%) had incomplete circumcisions, 3 (8.82%) had several skin bridges, and 2 (5.88%) had incomplete circumcisions with glans damage. All of the patients who had circumcision errors were successfully treated. There wasn’t any death.
CONCLUSIONS: Male circumcision is customary in Pakistan for religious reasons and may occur at a broad range of ages. In contemporary culture, quackery-performed circumcision and the ensuing consequences are still common. When carried out by skilled medical experts in the aseptic environment of the operating room, the technique is secure and devoid of any significant difficulties; for this reason, it should be promoted.
KEYWORDS: Circumcision, Anesthesia, Analgesia