title: Complications of neonatal circumcision requiring surgical intervention in a developing country.
abstract: OBJECTIVE
  The recent scale-up in neonatal circumcision (NC) may require strategies to reduce complications. This study evaluated complications of NC requiring surgery.
  
  
  METHODS
  A prospective analysis of 64 patients with complications of NC managed by surgery between June 2006 and May 2012 at the University of Nigeria Teaching hospital Enugu was conducted.
  
  
  RESULTS
  Circumcision was performed by nurse in 54 (84.4%) patients, traditional practitioner in 5 (7.8%) and doctor in 5 (7.8%), at a median age of 9 days (range: 2-21 days). Complications noticed 1 day to 7 years (mean: 7.8 months) after circumcision were glanular adhesion in 27 (42.2%) children, meatal stenosis in 14 (21.9%), urethrocutaneous fistula in 11 (17.2%), trapped penis in 5 (7.8%), implantation dermoid in 4 (6.2%) and glans amputation in 3 (4.7%). After treatment, outcome was good in 59 (92.2%) patients, whereas 5 (7.8%) had residual defect.
  
  
  CONCLUSIONS
  NC may be associated with serious complications in our setting. Adequate training of providers on safe procedure may minimize complications.
authors.affiliation: Department of Paediatric Surgery, University of Nigeria Teaching Hospital, 400001 Enugu, Nigeria. sebekenze@gmail.com
authors.forename: Sebastian O
authors.initials: SO
authors.lastname: Ekenze
authors.forename: Uchechukwu O
authors.initials: UO
authors.lastname: Ezomike
mesh_terms: D002648:Child; D002675:Child, Preschool; D002944:Circumcision, Male / Q000009:adverse effects* / Q000534:rehabilitation / Q000706:statistics & numerical data; D017577:Cutaneous Fistula / Q000601:surgery; D006784:Hospitals, Teaching; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009549:Nigeria / Q000453:epidemiology; D010413:Penis / Q000293:injuries / Q000601:surgery; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology / Q000601:surgery*; D011446:Prospective Studies; D016896:Treatment Outcome
keywords: challenges; cost; developing country; neonatal circumcision; outcome; surgical complications