title: Complications of self-circumcision: a case report and proposal.
abstract: BACKGROUND
  Male circumcision is a common surgical technique that has been performed worldwide for thousands of years for medical, social, cultural, and religious reasons. It is usually conducted in childhood in a clinical setting, but the practice of adult self-circumcision has led to a market for nonmedically approved self-circumcision devices that can be purchased via the Internet.
  
  
  OBJECTIVE
  The aims of this report are to report the case of a 30-year-old white man who suffered complications after trying to perform a self-circumcision with a nonmedically approved device purchased via the Internet, and to propose that urologists should take the lead in investigating the problem of male self-circumcision.
  
  
  METHODS
  This case report documents the presentation and treatment of an attempted self-circumcision.
  
  
  RESULTS
  The attempted self-circumcision was carried out without local anaesthetic and resulted in an incision in the foreskin. The patient presented with uncontrollable local bleeding 2 days after carrying out the procedure. Although questioned as to why he had attempted self-circumcision, the patient was reluctant and/or unable to explain his reasons. Daily local wound care and topical antibiotics resulted in complete wound healing after 2 months, and a clinical clamp circumcision was conducted to treat the remaining severe phimosis.
  
  
  CONCLUSIONS
  Data on the prevalence and outcomes associated with the use of self-circumcision devices are few. The clinicians who treat the complications are best placed to collect data on self-circumcision and should publish case studies. Eventually there may be sufficient understanding of the sector of the population at risk from this practice to educate those likely to attempt self-circumcision, and enough evidence of harm for controls to be placed on the sale of these nonmedically approved devices via the Internet.
authors.affiliation: Department of Urology, University of Florence, Uro-Andrological Unit, Florence, Italy. anatali@dada.it
authors.forename: Alessandro
authors.initials: A
authors.lastname: Natali
authors.forename: Mario Alberto
authors.initials: MA
authors.lastname: Rossetti
mesh_terms: D000328:Adult; D002944:Circumcision, Male / Q000009:adverse effects* / Q000295:instrumentation; D004487:Edema / Q000209:etiology*; D006801:Humans; D020407:Internet; D008297:Male; D010409:Penile Diseases / Q000209:etiology*; D010688:Phimosis / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology*; D019106:Postoperative Hemorrhage / Q000209:etiology*; D012086:Reoperation; D012648:Self Care / Q000009:adverse effects* / Q000295:instrumentation; D016728:Self-Injurious Behavior / Q000150:complications*; D013525:Surgical Instruments