Circumcision-related tragedies seen in children at the Komfo Anokye Teaching Hospital, Kumasi, Ghana.

Kwaku Addai Arhin Appiah,Christian Kofi Gyasi-Sarpong,Ken Aboah,Kofi Baah-Nyamekye,Edwin Mwintiereh Yenli,George Amoah,Benjamin Frimpong-Twumasi,Patrick Opoku Manu Maison,Douglas Arthur,Dennis Odai Laryea,Isaac Opoku Antwi,Roland Azorliade,Samuel Kodzo Togbe,Kwaku Otu-Boateng

doi:10.1186/s12894-016-0183-1

Abstract

BackgroundCircumcision is a common minor surgical procedure and it is performed to a varying extent across countries and religions. Despite being a minor surgical procedure, major complications may result from it. In Ghana, although commonly practiced, circumcision-related injuries have not been well documented. This study is to describe the scope of circumcision-related injuries seen at the Komfo Anokye Teaching Hospital in Kumasi, Ghana.MethodsThe study was conducted at the Urology Unit of the Komfo Anokye Teaching Hospital in Kumasi. Consecutive cases of circumcision-related injuries seen at the unit over an 18 month period were identified and included in the study. Data was collected using a structured questionnaire. Data was entered and analysed using SPSS version 16. Charts and tables were generated using Microsoft Excel.ResultsA total of 72 cases of circumcision-related injuries were recorded during the 18 month period. Urethrocutaneous fistula was the commonest injury recorded, accounting for 77.8 % of cases. Other injuries recorded were glans amputations (6.9 %); iatrogenic hypospadias (5.6 %), and epidermal inclusion cysts (2.8 %). The majority of children were circumcised in health facilities (75 %) and nurses were the leading providers (77.8 %). The majority of circumcisions were conducted in the neonatal period (94.7 %).ConclusionCircumcision-related injuries commonly occurred in the neonatal period. Most of the injuries happened in health facilities. The most common injury recorded was urethrocutaneous fistula but the most tragic was penile amputation. There is the need for education and training of providers to minimise circumcision-related injuries in Ghana.

Highlights

Circumcision is a common minor surgical procedure and it is performed to a varying extent across countries and religions
Urologists at the unit conducted penile examinations and assigned eligible patients specific injury categories as haemorrhage, urethrocutaneous fistula, penile amputation, iatrogenic hypospadias, skin bridges, excess foreskins, epidermal inclusion cysts, buried penis or any other injury that was deemed to be as a result of circumcision
The timing of circumcision among children in this study suggests an early age of circumcision in Ghana as over 87 % of cases had circumcision done in the neonatal period (Table 1)

Summary

Introduction

Circumcision is a common minor surgical procedure and it is performed to a varying extent across countries and religions. Despite being a minor surgical procedure, major complications may result from it. In Ghana, commonly practiced, circumcision-related injuries have not been well documented. This study is to describe the scope of circumcision-related injuries seen at the Komfo Anokye Teaching Hospital in Kumasi, Ghana. While generally regarded as a minor surgical procedure, major complications may result from it [1,2,3,4]. In Ghana, data on circumcision-related injuries is scanty. This crosssectional observational study was designed to describe the scope of circumcision-related injuries seen at the Komfo Anokye Teaching Hospital in Kumasi, Ghana

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Conclusion