Complications of non-medical assisted circumcision in Burkina Faso. Clinical presentation, management, and outcomes - about 23 cases and literature review

Abstract

OBJECTIVE: To report the clinical presentation of circumcision complications encountered at our center and evaluate their management and outcomes. PATIENTS AND METHODS: A retrospective and descriptive study was conducted at Souro Sanou University Hospital between January 1, 2014, and December 31, 2018. All patients presenting with circumcision complications were included. Parameters related to clinical aspects of circumcision complication, their management and outcomes were studied. RESULTS: During the study period, 23 cases of circumcision complications were reported. The average age of patients with circumcision complications was 8.3 years ± 3.5 years, with ages ranging from 18 months to 65 years old. Circumcision was performed by nurses in 12 cases and traditional practitioners in 11 cases. Observed complications included post-circumcision bleeding and hematoma (n = 8), leading to surgical exploration and hemostasis; total or partial amputation of the glans (n = 4), requiring regularization and meatoplasty; infectious complications (n = 3), managed with combined resuscitation, antibiotic administration, and penile debridement; penile urethra-cutaneous fistulas (n = 2), which were repaired; and stenosis of the external urethral meatus (n = 2), treated by meatoplasty. No deaths were reported. CONCLUSIONS: Circumcision complications presented various clinical manifestations, including hemorrhagic complications, glans amputation, infection, penile fistulas, and meatal stenosis. These complications were effectively managed from a functional perspective; however, aesthetic issues may persist. Emphasis should be placed on preventing these complications by ensuring circumcisions are performed by appropriately trained medical professionals.