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S15-10
(P)
THE COMPARISON OF POSTOPERATIVE COMPLICATIONS OF PARTIAL AND TOTAL
CIRCUMCISION IN CHILDREN
Jan TRACHTA, Cecilie SIDLOVA, Jiri MORAVEK and Jan KRIZ
Motol University Hospital, Charles University in Prague, The Czech Republic, Paediatric Surgery, Prague, CZECH
REPUBLIC
PURPOSE
To compare the rate and types of complications in boys who underwent partial and total circumcision for pathological
phimosis.
MATERIAL AND METHODS
We retrospectively reviewed the records of patients under 18 years of age operated for phimosis from 2009 to 2012.
Out of 419 identified boys, the following were excluded: all after preputioplasty (37), lost to follow-up (31) and
circumcised for religious reasons (4). Out of 347 patients included in the analysis, 273 underwent partial (group P) and
74 total (group T) circumcision. The complications were divided into short-term (within the first month), long-term, mild
and severe with the need of re-operation. The data were analysed by the Fisher's exact test using R statistical package,
version 3.1.1. P-values less than 5% were considered as statistically significant.
RESULTS
The age distribution in groups P and T was similar with the mean 6.5 and 5.7 years, respectively. The short-term
complication rate was significantly higher in P compared to group T (23% to 11%, p-value 0.022) and also higher in the
long-term (22% to 9%, p-value 0.013), making the overall complication rate 36% to 19%, p-value 0.005. Of all the
complications 97% were mild (painful swelling, scarring, adhesions, infection and haemorrhage). They all resolved
during the follow-up 0.2 to 47.3 months after the operation (the mean 2.7 months). 3% were severe, all in group P
(scarring 8x, paraphimosis 2x, poor cosmesis 1x).
CONCLUSIONS
Partial circumcision (excision of the distal fibrotic ring) is preferred due to cultural habits in our country. The boys and
their parents should be warned about the high rate of expected complications that is the double compared to total
cicumcision.