Abstract Book - 26th ESPU Congress, Joint Meeting with ICCS + SPU + AAP/SOU + AAPU + SFU

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11:29 - 11:32
S15-2 (PP)
★ CHECKLIST ASSESSMENT TOOL TO ASSESS SUITABILITY AND SUCCESS OF
NEWBORN CLAMP CIRCUMCISION - A PROSPECTIVE STUDY
Charles CONCODORA1, Max MAIZELS2, Gregory DEAN 1, Dana WEISS3, Seth ALPERT4, John EDMONDSON5, Jack ELDER6,
Anthony HERNDON7, James ELMORE8 and Karen RYCHLIK 2
1) Temple University Hospital, Urology, Philadelphia, USA - 2) Ann & Robert H. Lurie Children's Hospital of Chicago,
Urology, Chicago, USA - 3) Childrens Hospital of Philadelphia, Urology, Philadelphia, USA - 4) Nationwide Children's
Hospital, Urology, Columbus, USA - 5) Children's Urology of Virginia, Urology, Richmond, USA - 6) Henry Ford Hospital,
Urology, Detroit, USA - 7) University of Virginia School of Medicine, Urology, Charlottesville, USA - 8) Emory University
School of Medicine, Urology, Atlanta, USA
PURPOSE
We are responding to the American Academy of Pediatrics Task Force on Circumcision call to establish standards for
Newborn Clamp Circumcision (NCC). Therefore, the authors collaborated to develop checklist criteria to assess which
newborns are suited to NCC and also to assess NCC success.
MATERIAL AND METHODS
A national multi-institutional collaboration was created to obtain consensus on criteria to be used to assess patient
suitability for NCC and to assess success outcomes. Criteria include elements from detailed medical history, bedside
physical examination, and post-circumcision follow-up. All checklist criteria must be met to suffice suitability and
success.
Patients desiring NCC were enrolled consecutively and prospectively. The checklist was followed to determine which
newborns were suited to NCC, and NCC was done in those cases. At follow-up, the checklist was followed to assess if
NCC resulted in success, and if there were complications.
RESULTS
A total of 199 cases were enrolled prospectively and consecutively. Mean age was 16 days old (range 1 – 117). There
were 134 (67%) cases deemed suited to NCC and underwent NCC. Post-circumcision assessment was done at mean
interval of 8 days (range 4 – 25) and showed 100% success rate without complications. There were 65 (23%) cases
deemed unsuited for NCC: penile torsion (n=20), chordee (n=16), buried penis syndrome (n=15), hypospadias (n=7),
penoscrotal web (n=5), and bleeding diathesis (n=2).
CONCLUSIONS
We have created and used a checklist assessment tool to identify which newborns are suited for NCC and to assess NCC
success. We found about 65% of newborns are suited for NCC and show a 100% success rate without complications in
this study. We believe following a NCC Checklist will reduce the incidence of NCC in unsuitable cases and thereby
decrease the likelihood of NCC complications.