Commentary to: Sutureless circumcision using monopolar diathermy and 2-octyl cyanoacrylate is safe and effective in a cohort of 634 post-neonatal prepubescent boys

Abstract

In the late ’90s, a paediatric surgical resident was called to the emergency department to examine a neonate for a potential complication after ritual circumcision. The resident confirmed complete gangrene of the penile body following the application of an unconfirmed chemical substance to stop bleeding. Complete amputation of the penile body occurred a few days later. The circumcision was performed by a physician who seemed to be a relative to the child. This resident was me. Similar cases of penile gangrene after circumcision are reported in the literature [ 1 Rizvi S.A. Naqvi S.A. Hussain M. Hasan A.S. Religious circumcision: a Muslim view. BJU Int. 1999; 83: 13-16 Google Scholar , 2 Altokhais T.I. Electrosurgery use in circumcision in children: is it safe?. Urol Ann. 2017; 9: 1-3 Google Scholar , 3 Seleim H.M. Elbarbary M.M. Major penile injuries as a result of cautery during newborn circumcision. JPS. 2016; 51: 1532-1537 Google Scholar ]. Sutureless circumcision using monopolar diathermy and 2-octyl cyanoacrylate is safe and effective in a cohort of 634 post-neonatal prepubescent boysJournal of Pediatric UrologyVol. 18Issue 6PreviewCircumcision is the most commonly performed surgical procedure in the world, with one-third of males circumcised globally. Post-neonatal, prepubescent sutured circumcision demonstrates complication rates ranging from 1.7% to 9.1%. We have previously reported that 2-octyl cyanoacrylate (2-OCA, Dermabond, Ethicon) primary circumcision (PC) and circumcision revision (CR) in prepubescent children demonstrated superior cosmesis, shorter operating room (OR) times and cost savings. Full-Text PDF Response to commentary re no instruments, no sutures, no worries: Circumcision using monopolar diathermy and 2-octyl cyanoacrylate is safe and effective in a cohort of 634 post-neonatal prepubescent boysJournal of Pediatric UrologyVol. 18Issue 6PreviewJust as there is debate about whether to perform circumcision, so too are there opinions about how to do them. Sadly, the reviewer witnessed a devastating complication following a circumcision. This anecdotal experience may have blinded their view of circumcision in general. However, we must remember that electrocautery and chemical cautery are two distinct entities. The reader of our manuscript should be reassured that the procedure we describe is both safe and effective when performed by trained experts. Full-Text PDF