Circumcision-related tragedies seen in children at the Komfo Anokye Teaching Hospital, Kumasi, Ghana.
BACKGROUND
Circumcision is a common minor surgical procedure and it is performed to a varying extent across countries and religions. Despite being a minor surgical procedure, major complications may result from it. In Ghana, although commonly practiced, circumcision-related injuries have not been well documented. This study is to describe the scope of circumcision-related injuries seen at the Komfo Anokye Teaching Hospital in Kumasi, Ghana.


METHODS
The study was conducted at the Urology Unit of the Komfo Anokye Teaching Hospital in Kumasi. Consecutive cases of circumcision-related injuries seen at the unit over an 18 month period were identified and included in the study. Data was collected using a structured questionnaire. Data was entered and analysed using SPSS version 16. Charts and tables were generated using Microsoft Excel.


RESULTS
A total of 72 cases of circumcision-related injuries were recorded during the 18 month period. Urethrocutaneous fistula was the commonest injury recorded, accounting for 77.8 % of cases. Other injuries recorded were glans amputations (6.9 %); iatrogenic hypospadias (5.6 %), and epidermal inclusion cysts (2.8 %). The majority of children were circumcised in health facilities (75 %) and nurses were the leading providers (77.8 %). The majority of circumcisions were conducted in the neonatal period (94.7 %).


CONCLUSIONS
Circumcision-related injuries commonly occurred in the neonatal period. Most of the injuries happened in health facilities. The most common injury recorded was urethrocutaneous fistula but the most tragic was penile amputation. There is the need for education and training of providers to minimise circumcision-related injuries in Ghana.
Department of Surgery, Komfo Anokye Teaching Hospital, Kumasi, Ghana. addaiarhin@yahoo.com.
Kwaku Addai Arhin
http://orcid.org/0000-0002-7583-8938
KA
Appiah
Department of Surgery, School of Medical Sciences-KNUST, Kumasi, Ghana.
Christian Kofi
CK
Gyasi-Sarpong
Department of Surgery, Komfo Anokye Teaching Hospital, Kumasi, Ghana.
Roland
R
Azorliade
Department of Surgery, School of Medical Sciences-KNUST, Kumasi, Ghana.
Ken
K
Aboah
Public Health Unit, Komfo Anokye Teaching Hospital, Kumasi, Ghana.
Dennis Odai
DO
Laryea
Department of Surgery, Komfo Anokye Teaching Hospital, Kumasi, Ghana.
Kwaku
K
Otu-Boateng
Department of Surgery, Komfo Anokye Teaching Hospital, Kumasi, Ghana.
Kofi
K
Baah-Nyamekye
Department of Surgery, Komfo Anokye Teaching Hospital, Kumasi, Ghana.
Patrick Opoku Manu
PO
Maison
Department of Surgery, Komfo Anokye Teaching Hospital, Kumasi, Ghana.
Douglas
D
Arthur
Department of Surgery, Komfo Anokye Teaching Hospital, Kumasi, Ghana.
Isaac Opoku
IO
Antwi
Department of Surgery, Komfo Anokye Teaching Hospital, Kumasi, Ghana.
Benjamin
B
Frimpong-Twumasi
Department of Surgery, Tamale Teaching Hospital, Tamale, Ghana.
Edwin Mwintiereh
EM
Yenli
Department of Surgery, Komfo Anokye Teaching Hospital, Kumasi, Ghana.
Samuel Kodzo
SK
Togbe
Department of Surgery, Komfo Anokye Teaching Hospital, Kumasi, Ghana.
George
G
Amoah
D002648:Child; D002675:Child, Preschool; D002944:Circumcision, Male / Q000009:adverse effects*; D003430:Cross-Sectional Studies; D005869:Ghana; D006784:Hospitals, Teaching; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010413:Penis / Q000293:injuries*; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*
Circumcision; Circumcision injury; Ghana; Penile amputation; Urethrocutaneous fistula