title: The relationship between obesity and complications after neonatal circumcision.
abstract: OBJECTIVE
  Penile adhesions with hidden penis and penile skin bridges are complications after neonatal circumcision that seem to develop more often in overweight children. They could possibly be avoided if there were neonatal parameters predicting circumcision complications. We hypothesized that penile adhesions with hidden penis and skin bridges may be predicted by the height and weight of a newborn.
  
  
  METHODS
  We performed an institutional review board approved case-control study. Boys younger than 5 years who presented for evaluation of penile adhesions with hidden penis and/or penile skin bridges after newborn circumcision were compared to boys of the same age who were circumcised at birth and did not have penile adhesions with hidden penis and/or skin bridges when evaluated for cryptorchidism or hernia/hydrocele. Weight for length percentiles were compared at birth and at urological evaluation.
  
  
  RESULTS
  We evaluated 51 patients with penile adhesions and hidden penis after newborn circumcision, and compared them to 33 age matched controls. Boys with hidden penis had a statistically higher weight for length percentile at birth and at urological evaluation. However, in boys with penile skin bridges there was no statistical difference in the weight for length percentile at either time.
  
  
  CONCLUSIONS
  An increased weight for length percentile in male infants before and after circumcision may be associated with penile adhesions with hidden penis but not penile skin bridges. These parameters should be considered before newborn circumcision when counseling parents, and after circumcision since early recognition of obesity might indicate the need for diligent genital hygiene to try to prevent post-circumcision complications.
authors.affiliation: Department of Urology, Naval Medical Center, San Diego, California 92134-5000, USA. douglas.storm@med.navy.mil
authors.forename: Douglas W
authors.initials: DW
authors.lastname: Storm
authors.forename: Cheryl
authors.initials: C
authors.lastname: Baxter
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Koff
authors.forename: Seth
authors.initials: S
authors.lastname: Alpert
mesh_terms: D015992:Body Mass Index; D002675:Child, Preschool; D002944:Circumcision, Male / Q000009:adverse effects* / Q000379:methods; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009765:Obesity / Q000150:complications* / Q000453:epidemiology; D010409:Penile Diseases / Q000453:epidemiology / Q000209:etiology*; D011183:Postoperative Complications; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors; D014481:United States / Q000453:epidemiology