Complications during male circumcision are rare, being estimated to occur in 1 of every 500 procedures. These complications, which can be severe, include poor cosmetic outcome, bleeding, infection, injury to the penis and the removal of too much or too little skin.
Using “rare” for a 1 in 500 risk, when earlier the benefit of “avoiding the need for circumcision later in life” (about 1 in 2,000) is mentioned without qualification, is biased. The figure also applies to the best series. Less well organised services report rates up to 20%, e.g. Nigeria, click here. Since the manual is for use in developing countries the possibility of higher complication rates should be mentioned. Finally, Complications, which can be severe, include poor cosmetic outcome… is clearly designed to play down severity.
But more importantly, catastrophic complications are omitted altogether. Fully informed consent means telling people everything, however rare, which might alter the decision of a reasonable patient/parent. In gynaecology we mention the 1 in 10,000 risk of temporary colostomy after laparoscopic surgery for example. Unless we have a double standard for Africa, the complications below, which all appear elsewhere in the guide, should be mentioned. Italic text and pictures are all taken from the guide.
None of these complications are common, but they all occur. If infant circumcision programmes get rolled out widely in developing countries, it is inconceivable that everyone will read all 140 pages of the WHO manual In the real world sterilisation goes wrong, mismatched Yellen clamps get packed together, and diathermy and wrong sized Plastibells get used. Even if they don’t, infants wriggle. Parents should be told.
pics in link at top
in Britain (UK)
Complications are common, two boys a week are admitted to the Emergency Department in Birmingham Children’s Hospital and one boy a month comes close to death as a result of male circumcision.
Another baby hemorrhaging… Lucky to be alive and yet supposedly the risks are worth it? How is almost dying worth it? How is almost dying because of a medically unnecessary surgery being performed on a healthy infant worth it?