Can a routine circumcision go wrong?

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After a comprehensive review of the scientific evidence, the American Academy of Pediatrics found the health benefits of newborn male circumcision outweigh the risks. But the benefits are not great enough to recommend universal newborn circumcision. The AAP policy statement says the final decision should still be left up to parents in the context of their religious, ethical and cultural beliefs.

While circumcision is a common procedure with few risks, unfortunate errors still occur. Performed incorrectly, circumcision can cause problems from minor deformity to necessitating consideration of a sex change.

The most common mistake is when too much is removed, changing the shape of the penis so that it becomes curved more like a comma. This is even more noticeable when it’s erect and can also cause difficulty with urination due to the changed direction of the head of the penis. Later in life this could lead to ridicule from peers in situations such as shared changing areas or sexual partners. If the injury is severe enough, it could cause difficulties in sexual performance.

In one circumcision method, if the provider doesn’t carefully separate the foreskin from the head of the penis, one can misjudge where the head of the penis ends and may take part of it off. This can affect sensitivity and shape of the penis, possibly even sexual function. Some people used to use cauterization when performing circumcisions—the use of a heated element to burn the skin away and seal the wound at the same time. But this method has fallen mostly out of practice. It could leave burns and long term nerve and structural damage to the shaft of the penis.

There is also a condition called hypospadias. This is where the exit from the penis is not at the tip. If the person performing the circumcision doesn’t recognize this, they could make the abnormality worse, requiring reconstructive surgery.

In the most extreme and rare cases, when the penis is so severely damaged and is no longer a functional organ, parents may need to considered a complete gender modification.

The most obvious signs that something may have gone wrong during a circumcision are severe infection, difficulty urinating, pain and malformation of the penis.

This article was written by Dr. Charles Bowers

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