title: Penile necrosis due to priapism developed after circumcision in a patient with protein S deficiency.
abstract: BACKGROUND
  Hypercoagulable state is a complex condition with an abnormal propensity for thrombosis. The consequences of it due to thrombosis of veins and arteries are the most common cause of sickness.
  
  
  OBJECTIVE
  The present study is a report of a case describing penis necrosis after circumcision and evaluation of hypercoagulable state as a reason of it.
  
  
  METHODS
  l Nine-year-old boy referred from another hospital with the sequelae of the penile ischemia with discoloration of the penis after traditional circumcision.
  
  
  RESULTS
  The ischemic event developed 3 weeks after circumcision. Priapism that was treated with needed glandulocavernous shunt initially developed following circumcision. All values of routine blood count and blood biochemical analysis were within normal limits. Further, hematologic studies revealed that there might be a hypercoagulable state as a result of lower protein S level.
  
  
  CONCLUSIONS
  Circumcision is a common procedure frequently performed in many communities around the world. Although it is seen as an easy procedure and performed even by unauthorized medical stuff, it is not complication-free. Severe penile necrosis after circumcision should be treated on an individual basis, necessitating different techniques. Hypercoagulable state should be concerned and evaluated in such a complication. In short, circumcision has to be done by specialists who can handle such serious complications.
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, Acibadem University School of Medicine, Acibadem Bakirkoy Hospital, Bakirkoy, Istanbul, Turkey.
authors.forename: Halil I
authors.initials: HI
authors.lastname: Canter
authors.forename: Enis R
authors.initials: ER
authors.lastname: Coskuner
mesh_terms: D002648:Child; D002944:Circumcision, Male / Q000009:adverse effects*; D006801:Humans; D008297:Male; D009336:Necrosis; D010413:Penis / Q000473:pathology*; D011317:Priapism / Q000150:complications / Q000209:etiology* / Q000473:pathology; D018455:Protein S Deficiency / Q000150:complications*