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Complications of circumcision

Jenny H Yiee, MD
Laurence S Baskin, MD, FAAP
Section Editors
Charles J Lockwood, MD, MHCM
Martin I Lorin, MD
Duncan Wilcox, MD
Deputy Editor
Melanie S Kim, MD


Circumcision in the male refers to the surgical removal of the foreskin (ie, prepuce) of the penis. The procedure is centuries old and continues to be performed for a variety of religious, cultural, and medical reasons. Debate continues as to the utility of circumcision, The 2012 American Academy of Pediatrics (AAP) policy statement regarding newborn circumcision states, preventive health benefits of elective circumcision of male newborns outweigh the risks of the procedure," but did not recommend it for all newborns, instead leaving the decision to each parent [1]. Despite this controversy, circumcision is the most common operation in the United States. A survey in 1992 showed 77 percent of US-born men to be circumcised and 42 percent of non-United States born men to be circumcised [2].

Complications of circumcision and their management will be reviewed here. Circumcision technique and its risks and benefits are discussed separately. (See "Techniques for neonatal circumcision" and "Neonatal circumcision: Risks and benefits".)


Careful, meticulous attention to penile anatomy (figure 1) and the correct use of surgical equipment by trained clinicians can prevent most complications from circumcision.

The rate of procedure-related complications during and after circumcision in the neonate is approximately 2 to 6 per 1000 [3-5]. This rate increases 20-fold for boys who are circumcised between one and nine years of age, and 10-fold for those circumcised after 10 years of age [4]. Inadequate training of clinicians contributes to complications, as practitioners without formal training may not recognize congenital malformations (eg, congenital buried penis and penoscrotal webbing) that are more likely to result in poor results when using routine conventional methods (picture 1 and picture 2) [6]. Patients with these abnormalities should be referred to a pediatric urologist.

Most of these problems are readily treatable and cause no long-term effects. However, when complications occur, especially surgical complications, specialist referral may be required for evaluation and reoperation.

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Literature review current through: Sep 2017. | This topic last updated: Aug 03, 2016.
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  1. American Academy of Pediatrics Task Force on Circumcision. Male circumcision. Pediatrics 2012; 130:e756.
  2. Laumann EO, Masi CM, Zuckerman EW. Circumcision in the United States. Prevalence, prophylactic effects, and sexual practice. JAMA 1997; 277:1052.
  3. Wiswell TE, Geschke DW. Risks from circumcision during the first month of life compared with those for uncircumcised boys. Pediatrics 1989; 83:1011.
  4. El Bcheraoui C, Zhang X, Cooper CS, et al. Rates of adverse events associated with male circumcision in U.S. medical settings, 2001 to 2010. JAMA Pediatr 2014; 168:625.
  5. Srinivasan M, Hamvas C, Coplen D. Rates of Complications After Newborn Circumcision in a Well-Baby Nursery, Special Care Nursery, and Neonatal Intensive Care Unit. Clin Pediatr (Phila) 2015; 54:1185.
  6. Demaria J, Abdulla A, Pemberton J, et al. Are physicians performing neonatal circumcisions well-trained? Can Urol Assoc J 2013; 7:260.
  7. Neonatal circumcision revisited. Fetus and Newborn Committee, Canadian Paediatric Society. CMAJ 1996; 154:769.
  8. Williams N, Kapila L. Complications of circumcision. Br J Surg 1993; 80:1231.
  9. Scurlock JM, Pemberton PJ. Neonatal meningitis and circumcision. Med J Aust 1977; 1:332.
  10. Woodside JR. Necrotizing fasciitis after neonatal circumcision. Am J Dis Child 1980; 134:301.
  11. Baskin LS, Canning DA, Snyder HM, Duckett JW. Treating complications of circumcision. Pediatr Emerg Care 1996; 12:62.
  12. Weiss HA, Larke N, Halperin D, Schenker I. Complications of circumcision in male neonates, infants and children: a systematic review. BMC Urol 2010; 10:2.
  13. Bastos Netto JM, de Araújo JG Jr, de Almeida Noronha MF, et al. Prospective randomized trial comparing dissection with Plastibell® circumcision. J Pediatr Urol 2010; 6:572.
  14. Gee WF, Ansell JS. Neonatal circumcision: a ten-year overview: with comparison of the Gomco clamp and the Plastibell device. Pediatrics 1976; 58:824.
  15. Elder J. Abnormalities of the genitalia in boys and their surgical management. In: Campbell-Walsh Urology, 4th ed, Wein A, Kavoussi L, Novick A (Eds), Elsevier, Philadelphia 2007.
  16. Pieretti RV, Goldstein AM, Pieretti-Vanmarcke R. Late complications of newborn circumcision: a common and avoidable problem. Pediatr Surg Int 2010; 26:515.
  17. Krill AJ, Palmer LS, Palmer JS. Complications of circumcision. ScientificWorldJournal 2011; 11:2458.
  18. Baskin LS, Canning DA, Snyder HM 3rd, Duckett JW Jr. Surgical repair of urethral circumcision injuries. J Urol 1997; 158:2269.
  19. Gluckman GR, Stoller ML, Jacobs MM, Kogan BA. Newborn penile glans amputation during circumcision and successful reattachment. J Urol 1995; 153:778.
  20. Sherman J, Borer JG, Horowitz M, Glassberg KI. Circumcision: successful glanular reconstruction and survival following traumatic amputation. J Urol 1996; 156:842.
  21. Gearhart JP, Rock JA. Total ablation of the penis after circumcision with electrocautery: a method of management and long-term followup. J Urol 1989; 142:799.
  22. Thompson JH, Zmaj P, Cummings JM, Steinhardt GF. An approach for using full thickness skin grafts for complex penile surgeries in children. J Urol 2006; 175:1869.
  23. Van Howe RS. Variability in penile appearance and penile findings: a prospective study. Br J Urol 1997; 80:776.
  24. Ponsky LE, Ross JH, Knipper N, Kay R. Penile adhesions after neonatal circumcision. J Urol 2000; 164:495.
  25. Palmer LS, Palmer JS. The efficacy of topical betamethasone for treating phimosis: a comparison of two treatment regimens. Urology 2008; 72:68.
  26. Palmer LS, Palmer JS. Management of abnormal external genitalia in boys. In: Campbell-Walsh Urology, 12th ed, Wein AJ, Kavoussi LR, Partin AW, Peters CA (Eds), Elsevier, Philadelphia 2016.
  27. Casale AJ, Beck SD, Cain MP, et al. Concealed penis in childhood: a spectrum of etiology and treatment. J Urol 1999; 162:1165.
  28. Palmer JS, Elder JS, Palmer LS. The use of betamethasone to manage the trapped penis following neonatal circumcision. J Urol 2005; 174:1577.
  29. Eroğlu E, Bastian OW, Ozkan HC, et al. Buried penis after newborn circumcision. J Urol 2009; 181:1841.