Complications in Male Circumcision

1. Introduction:
. Definitions
. The ideal time for MC
2. Benefits of MC (Circumcision apparition)
3. Methods and techniques of circumcision
4. Anesthesia and analgesia for MC and its complications:
. General anesthesia
. Regional anesthesia
. Local anesthesia
. Topical anesthesia
5. Prevalence of MC complications:
. Factors affecting MC complication rate
. Classifications of MC complications
6. Bleeding complications:
. Blood supply of the penis
. Preoperative bleeding
. Intraoperative bleeding
. Postoperative bleeding
7. Infectious complications of circumcision:
. Post circumcision penile granuloma
. Post MC Balanitis
. Post MC Meatitis
. Meatal Ulcers
. Meatal stenosis
8. Non aesthetic circumcision scaring:
. Untidy circumcision
. Penile adhesions
. Skin bridge
. Incomplete circumcision
. Post MC concealed Penis (CP)
. Phimosis
. Keloid and hypertrophic scar
. Sutures marks
. Post MC smegma collections
9. Post MC Penile injuries:
. Penile skin loss
. Glans injury
. Meatal injury
. Urethral Injuries
. Corporal injury
. Vascular injuries and ischaemia
. Penile amputation
10. Prevention of MC complications

Circumcision remains as one of the most controversial topics in current urological practice. The most important argument against circumcision is the permanent change of anatomy, histology and function of the penis, with potential complications, with rates reported to be low in developed countries, whereas it may be up to 85% when circumcision is carried out by traditional circumcisers, rather than by medically trained professionals in developing countries. In some studies, reporting the complications of circumcision, primary haemorrhage was the most common (52%), whereas infection, meatal stenosis, incomplete circumcision, penile oedema, glandular injury, penile adhesions, iatrogenic hypospadias and urethral injuries were also detected at different rates.

At times minor complications after circumcision which cannot be avoided even when the procedure is undertaken by specialized pediatric surgeons or urologist, in a properly equipped centres; specially if the child or his penis is congenitally abnormal, the obvious examples are, circumcising a child with an excessive suprapubic fat or a child with webbed penis or microphallus.

This title aims to minimize complications of MC and to compete against its serious impact on men's' health, it will educate and teach physicians about potential complications and how they could manage it early on and avoid further patient problems.

This title will shed some light over the common as well the uncommon complications, which usually raise a debate about its management. There are different sets to classify MC complications: Either early, or late, minor or major, local or systemic, rare or common. Both rare and common complications will be discussed with comprehensive photos and illustrations for each complication and its operative remedy.