Circumcision – ancillary to surgery for abdominal wall, groin, scrotal and allied conditions

Abstract

Background: Circumcision is done mainly for cultural, religious or social reasons and communities that traditionally did not practice circumcision now routinely do so. However, there are complications of circumcision and conditions where it is contraindicated. The occurrence of circumcision complications from the community health units is substantial. The objective of this study is to review the practice of circumcision in addition to primary surgery at the Coast General Teaching and Referral Hospital, Mombasa, Kenya.

Methods: Surgery was done under general anaesthesia with many patients receiving caudal block as well. The primary surgery was done first, followed by circumcision. The dorsal slit circumcision was the most commonly used method and a few procedures were done using the sleeve circumcision technique. Most of the surgeries were done by the surgeon and some by senior surgical residents assisted or supervised by the surgeon.

Results: This review was done over an 8-year period (2015–2022). A total of 231 patients had circumcision in addition to the primary surgery. The mean age was 2 years, with a range of 1 month to 34 years. The surgeries comprised the following: inguinal herniotomy; umbilical hernia repair; orchidopexy for undescended testes, intermittent testicular torsion or after orchidectomy for torsion; reversal of vesicostomy; reconstruction of urethral diverticulum; unilateral subcutaneous mastectomy; and excision of a perineal dermoid. There were no significant complications of circumcision.

Conclusion: In societies where circumcision is practised, circumcision complementary to surgery for abdominal wall, groin, scrotal and allied conditions is commendable. It avoids further surgery for circumcision with its potential complications; especially when the procedure is performed in the community health units under local or inadequate, or even without, anaesthesia by persons with varied to no training. This practice also allows for proficient training of surgical residents in circumcision.