title: Newborn circumcision outcomes: are parents satisfied with the results?
abstract: OBJECTIVE
  Although physician-reported complications following circumcision are very low, parental satisfaction is not well documented. This study examined parental opinions and compared these with those of the medical professional.
  
  
  METHODS
  Physicians independently assessed complications and cosmetic outcome following the circumcision. Six weeks post-circumcision, parental report of complications, cosmetic outcome, and overall satisfaction were assessed.
  
  
  RESULTS
  Newborn infants (n = 710) were prospectively recruited and underwent either a Gomco [n = 552 (78 %)] or Plastibell(®) [n = 158 (22 %)] circumcision. Physician assessed complication rates were equivalent (Gomco 4.3 % versus Plastibell 5.1 %; p = 0.67), however, parental assessment found a much lower complication rate for Gomco 5.6 % versus Plastibell 12.0 % (p < 0.001). There was no difference between who performed the procedure nor between the techniques in regards to parental rating of overall satisfaction (excellent/good: Gomco 96.9 % versus Plastibell 95.6 %, p = 0.45). However, perceived post-operative pain as scored by parents was significantly higher in patients undergoing Plastibell procedure (6.4 % too much pain) versus Gomco (2.7 %; p = 0.05). Gomco accounted for 72.7 % of parental cosmetically unsatisfactory cases.
  
  
  CONCLUSIONS
  Clinicians and parents differed considerably in terms of opinion of cosmetic outcome and occurrence of post-operative complications. This study emphasizes the need for clinicians to better understand and address parental concerns before and after circumcision.
authors.affiliation: Department of Surgery, University of Michigan, Ann Arbor, MI, 48109, USA, jennjfreeman@me.com.
authors.forename: Jennifer J
authors.initials: JJ
authors.lastname: Freeman
authors.forename: Ariel U
authors.initials: AU
authors.lastname: Spencer
authors.forename: Robert A
authors.initials: RA
authors.lastname: Drongowski
authors.forename: Cosmas J M
authors.initials: CJ
authors.lastname: Vandeven
authors.forename: Barbara
authors.initials: B
authors.lastname: Apgar
authors.forename: Daniel H
authors.initials: DH
authors.lastname: Teitelbaum
mesh_terms: D002944:Circumcision, Male / Q000379:methods* / Q000706:statistics & numerical data; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008824:Michigan / Q000453:epidemiology; D010043:Outcome and Process Assessment, Health Care / Q000379:methods / Q000706:statistics & numerical data*; D010149:Postoperative Pain / Q000453:epidemiology; D010290:Parents; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies