Pediatric Hospitalist Circumcision Service: Analysis of Rate of Complications

1Washington University, St. Louis, MO

Meeting: Hospital Medicine 2014, March 24-27, Las Vegas, Nev.

Abstract number: 89

Background:

Circumcision is the most common neonatal surgical procedure in the world. There is regional variation in circumcision providers which includes obstetricians, pediatricians, family practitioners and non‐medical personnel. Pediatric hospitalists (PH) in many hospitals provide care to newborns in the nursery and are available to provide circumcision. There is no data regarding the safety and complication rates of circumcisions provided by PHI.Since 2007, PH at Washington University/St. Louis Children’s Hospital (SLCH) started performing circumcisions at the newborn nursery (NN), special care nursery (SCN), and neonatal intensive care unit (NICU). Our goal was to analyze the late complications of circumcisions performed by PH over 6 years.

Methods:

We identified all patients circumcised by PH from 2007‐2012 and analyzed the charts of any patient circumcised by PHs during this time period and were subsequently seen in the urology clinic or emergency department for circumcision related issues using the ICD‐9 codes 605 (redundant skin, adhesions, phimosis), 752.65 (trapped or concealed penis), 607.89 (inclusion cyst), 607.1 (balanitis).

Results:

Of the 7067 circumcisions performed during these years, 72.9 % were performed in the NN, 12% in the SCN, and 14.8% in the NICU. Altogether 62 patients (0.88%) visited the clinic or ER, 55 (0.78%) of which were due to circumcision complications (redundant foreskin, adhesions, skin bridges, entrapped penis, bleeding, and cicatrix). The remaining 7 patients visited the urology clinic following aborted circumcision due to concern for hypospadias. Of those with complications or return visits, 42 (67.7%) were circumcised in the NN, 3 (4.8%) were circumcised in the SCN, and 17 (27.4%) were circumcised in the NICU. The most common complication requiring clinic or ER visit was redundant foreskin or adhesions (31 patients, 0.44%). Of all the patients with complications, 24 (0.34%) required urological procedures, 12 (0.16%) of which were circumcision revisions.

Conclusions:

The rate of complications needing urology visits or circumcision revision among the patients circumcised by PH is low. This study demonstrates that transferring circumcision responsibility to PH trained in circumcision is safe.

To cite this abstract:

Hamvas C, Srinivasan M. Pediatric Hospitalist Circumcision Service: Analysis of Rate of Complications. Abstract published at Hospital Medicine 2014, March 24-27, Las Vegas, Nev. Abstract 89. Journal of Hospital Medicine. 2014; 9 (suppl 2). https://www.shmabstracts.com/abstract/pediatric-hospitalist-circumcision-service-analysis-of-rate-of-complications/. Accessed May 26, 2019.

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