Circumcision: What Your Baby Can't Tell You

"The Complications of Circumcision"

Excerpts from "The Complications of Circumcision,"
Chapter Eleven of Circumcision: The Painful Dilemma
By Rosemary Romberg
Bergin & Garvey Publishers, 1985
(Quoted with permission of the author.)

"The risks are many and can be devastating."

1. Meatal Ulceration -- "ammoniacal urine burns on the unprotected glans ... Possibly over half of all circumcised infants develop this." (p. 200)

2. Meatal Stricture -- "results from prolonged or repeated episodes of meatal ulceration. The repeatedly irritated meatus becomes narrowed ... pain and difficulty with urination ... can result in infections and kidney problems." (p. 204)

3. Hemorrhage -- "excessive bleeding ... a fairly common complication of circumcision." (p. 206)

4. Retention of Plastic Bell Ring -- "the ring fails to fall off and instead becomes buried under the skin along the shaft of the penis [and has to be surgically removed] ... leaves ... a permanent ridge or groove along the shaft of the penis." (p. 210)

5. Concealed Penis -- "the penile shaft, following circumcision, retreats into the surrounding skin and fatty area and cannot be seen." [Must be corrected surgically.] (p. 211)

6. Urethral Fistula -- "a hole going from the side of the male urethra to the outside of the penis ... results either from accidental crushing of the urethra by the circumcision clamp, an abnormality in the urethra, or from a stitch placed in the underside of the penis to control excessive bleeding at the site of the frenulum." (p. 214)

7. Phimosis of Remaining Foreskin -- "occasionally the remaining piece of foreskin becomes tightly attached to the sides of the glans." (p. 215)

8. Urinary Retention -- "Occasionally a baby will not urinate for several hours following circumcision. Sometimes the cause is an overly tight bandage wrapped around the wound. In other instances the cause is less clear." (p. 217)

9. Glans Necrosis -- "the death of body tissue ... has happened to the glans following circumcision due to an overly tight bandage or a Plasti-bell ring that is too small." (p. 218)

10. Injury and Loss of Glans -- "Occasionally the glans can be injured or entirely cut off during circum- cision ... Usually a permanent deformity results." (p. 219)

11. Excessive Skin Loss -- "devastating complications result from cutting off too much skin ... Excessive skin loss can result from the operator severing too much foreskin, from infection of the wound resulting in tissue death, or from a burn caused by an electrocautery device. Sometimes the entire penile shaft becomes denuded and skin grafting is necessary ... as the individual grows older his penile skin becomes too tight, causing discomfort on erection." (p. 219)

12. Skin Bridge -- "a complication in healing of the [circumcision] wound, by which a piece of skin from the shaft of the penis has become attached to the glans, or another point along the shaft, forming a bridge that must be surgically corrected." (p. 221)

13. Vomiting, Apneic Spells -- "cessation of breathing, usually for a short period of time ... can be life-threatening." [Baby cries from pain. Mother nurses baby. Baby vomits and inhales vomit.] (p. 222)

14. Sewing of Penile Skin to Glans -- "Sewing the skin edge to the glans, with consequent burying of the corona. " (p. 223)

15. Laceration of Penile or Scrotal Skin -- "Accidental laceration of the penile skin and scrotum following circumcision has been seen." (p. 223)

16. Undetected Hypospadias -- "a congenital deformity in which a fistula naturally occurs in the underside of the penis ... corrected by plastic surgery. The foreskin provides an easily available piece of tissue for use in skin grafting ... If an infant with hypospadias is ... circumcised, this potentially useful piece of skin has been destroyed and the operator must resort to more complicated types of skin grafts to reconstruct the penis." (p. 223)

17. Preputial Cysts -- "an abnormal, closed pocket of body tissue which contains fluid or solid material. Occasionally cysts develop along the remaining edges of foreskin at the site where the skin was severed." (p. 223)

18. Complications of Anesthesia -- "Complications can ensue from use of any type of anesthesia for any medical procedure, including circumcision." (p. 224)

19. Tuberculosis and other Diseases from Mezizah -- "Mezizah [rarely done today] is the third step of the Jewish ritual circumcision ceremony, in which the mohel applies his mouth to the fresh circumcision wound. Diseases have been spread due to this practice." (p. 225)

20. Strangulation of the Glans by Hair -- "long strands of human hair wrapped around the coronal sulcus." (p. 225)

21. Recurrence of Pneumothorax -- "a collection of air or gas in the membranes that surround the lungs or pleural cavity ... an infant developed a pneumothorax as a result of mechanical assistance with breathing for severe respiratory distress at birth ... [then] the infant was circumcised. His excessive crying from the pain of the operation caused the pneumothorax to recur." (p. 225)

22. Pulmonary Embolism -- "a clot of blood which travels through the circulatory system and becomes lodged in one of the blood vessels in the lungs. This causes severe breathing difficulties and can result in death." (p. 226)

23. Keloid Formation -- "an abnormal development consisting of a raised, firm, thickened, red piece of scar tissue. Such a formation at the site of circumcision creates a grotesque deformation of the organ, with obstruction of its function." (p. 226)

24. Lymphedema or Elephantiasis of Skin -- "swelling or obstruction of the lymph vessels ... can result from circumcision." (p. 226)

25. Reaction of Older Sibling -- " her two-year-old son had tried to amputate his [own] penis and was bleeding profusely ... had witnessed his baby brother's ritual circumcision." (p. 227)

26. Cosmetic Problems -- "The Gomco clamp and Plasti-bell devices ... if applied crookedly can ... result in cosmetic problems. Older methods such as smashing the skin with a hemostat and slicing it off present greater risk that an uneven cut will result." (p. 228)

27. Loss of Penis -- "There have been cases in which the penis has been lost due to circumcision ... In some cases enough penile shaft remained so that after extensive operations a functional penis could be reconstructed. In other cases the child has been surgically made into a girl." (p. 228)

28. Death [Death as a result of circumcision is discussed on pages viii, 68, 198, 207, 208, 209-210, 224 and 299.]