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Pediatric circumcision

Brian J Morris, Jeffrey D Klausner, John N Krieger, Bradley J Willcox, Pierre D Crouse, Neil Pollock
INTRODUCTION: The Canadian Pediatrics Society (CPS) recently released a position statement on early infant (newborn) male circumcision (EIMC). It concluded that since benefits do not exceed risks, circumcision should only be performed on boys in high-risk populations or circumstances. This contradicts recommendations by the American Academy of Pediatrics and the Centers for Disease Control and Prevention (CDC) whose policies each support more widespread implementation of EIMC. Here we review the CPS statement, particularly its risk-benefit analysis, to determine the basis for this disparity...
October 2016: Canadian Journal of Urology
Kumara V Nibhanipudi
OBJECTIVE: To determine the incidence of urinary tract infections (UTIs) in infants and children (4 months to 6 years of age) with febrile diarrhea, as outpatients. METHODS: This was a prospective institutional review board-approved study. patients (between 4 months and 6 years of age) were enrolled in the study who presented to the pediatric emergency room with a complaint of fever (rectal temperature 101°F or more) and diarrhea (watery stools >3 in number)...
2016: Global Pediatric Health
Michael A Granieri, Joseph J Fantony, Jonathan C Routh
We report the first documented case of high flow priapism after circumcision with dorsal penile nerve block. A 7-year-old male who had undergone circumcision three years before presented to our institution with a 3-year history of persistent nonpainful erections. Workup revealed a high flow priapism and, after discussion of the management options, the patient's family elected continued observation.
2016: Case Reports in Pediatrics
K Eckert, N Janssen, M Franz, P Liedgens
BACKGROUND: Removing boys' foreskins, even for medical reasons, is increasingly and critically discussed. The aim of this study is to retrospectively verify if the indication for the removal of boys' foreskins was justified. The study is based on the records of boys who underwent preputial operation in an outpatient medical office for pediatric surgery. METHODS: Preoperative clinical findings, complaints, applied conservative and/or surgical procedures and histological results of the resected foreskins of boys, who underwent preputial operation between 2013-2015, were retrospectively analyzed...
September 16, 2016: Der Urologe. Ausg. A
Brian J Morris, John N Krieger, Jeffrey D Klausner
We evaluate recent claims opposing infant male circumcision, a procedure now supported by the evidence-based policy of the American Academy of Pediatrics. We find those criticisms depend on speculative claims about the foreskin and obfuscation of the strong scientific evidence supporting pediatric policy development. An argument that circumcision should be delayed to allow a boy to make up his own mind as an adult fails to appreciate the psychological, scheduling and financial burdens later circumcision entails, so reducing the likelihood that it will occur...
August 8, 2016: World Journal of Clinical Pediatrics
Katherine W Gonzalez, Brian G Dalton, Brendan Kurtz, Michael C Keirsey, Tolulope A Oyetunji, Shawn D St Peter
BACKGROUND: Wound classification has catapulted to the forefront of surgical literature and quality care discussions. However, it has not been validated in laparoscopy or children. We analyzed pediatric infection rates based on wound classification and reviewed the most common noninfectious complications which could be a more appropriate measure for quality assessment. METHODS: We performed a retrospective review of 800 patients from 2011 to 2014 undergoing common procedures at a tertiary pediatric hospital...
November 2016: Journal of Pediatric Surgery
R E Selekman, I E Allen, H L Copp
INTRODUCTION: Urinary tract infection (UTI) affects 10% of girls and 3% of boys by age 16. Both the American Academy of Pediatrics and National Institute for Health and Clinical Excellence Guidelines recommend urine testing prior to initiation of antibiotic treatment and the use of local antibiograms to guide empiric antibiotic therapy. Urine culture results not only provide the opportunity to halt empiric therapy if there is no bacterial growth, but also allow for tailoring of broad-spectrum therapy...
July 5, 2016: Journal of Pediatric Urology
Richard Otto, Grant Evans, Christopher Boniquit, Dennis Peppas, Jeffrey Leslie
OBJECTIVE: To identify why parents who want their child circumcised do not have them circumcised before the window for new born circumcision (NBC) closes. We evaluate many patients in our pediatric urology clinic for circumcision in the operating room (OR) which is associated with increased inconvenience, morbidity and cost. METHODS: From 2010-2013 we surveyed 53 parents seeking NBC for their sons less than one month old. We surveyed a second group of 51 parents with sons between one month and two years old seeking OR circumcision...
July 19, 2016: Urology
Charles W Concodora, Max Maizels, Gregory E Dean, Dana A Weiss, Seth A Alpert, John D Edmondson, Jack S Elder, Anthony Herndon, James M Elmore, Karen Rychlik
BACKGROUND: The American Academy of Pediatrics (AAP) Task Force on Circumcision has called for the development of standards of trainee proficiency in regards to evaluation and technique for neonatal clamp circumcision (NCC). At the present time, there is no standardized or general consensus on patient selection for NCC. An improved method to evaluate newborns for NCC is an important first step in this process. Therefore, the authors collaborated to identify criteria useful in the evaluation of newborns for suitability for NCC, and for assessment of success after NCC and have named it "Checklist Assessment for Neonatal Clamp Circumcision Suitability...
August 2016: Journal of Pediatric Urology
J Steven Svoboda, Peter W Adler, Robert S Van Howe
The foreskin is a complex structure that protects and moisturizes the head of the penis, and, being the most densely innervated and sensitive portion of the penis, is essential to providing the complete sexual response. Circumcision-the removal of this structure-is non-therapeutic, painful, irreversible surgery that also risks serious physical injury, psychological sequelae, and death. Men rarely volunteer for it, and increasingly circumcised men are expressing their resentment about it.Circumcision is usually performed for religious, cultural and personal reasons...
June 2016: Journal of Law, Medicine & Ethics: a Journal of the American Society of Law, Medicine & Ethics
Michael T Brady
Newborn male circumcision is a minor surgical procedure that has generated significant controversy. Accumulating evidence supports significant health benefits, most notably reductions in urinary tract infections, acquisition of HIV and a number of other sexually transmitted infections, penile cancer, phimosis, paraphimosis, balanitis and lichen sclerosis. While circumcision, like any surgical procedure, has risks for complications, they occur in less than 1 in 500 infants circumcised and most are minor and require minimal intervention...
June 2016: Journal of Law, Medicine & Ethics: a Journal of the American Society of Law, Medicine & Ethics
Noah Kojima, Claire C Bristow, Neil Pollock, Pierre Crouse, Harry Theodore, Jerry Bonhomme, Claire F Stéphanie Gaston, Jessy G Dévieux, Jean William Pape, Jeffrey D Klausner
Male circumcision is highly protective against urinary tract infections, inflammatory conditions of the penis, sexually transmitted infections, and urogenital cancers. We aimed to reintroduce newborn male circumcision through the creation of a training program in Port-au-Prince, Haiti-an area with a considerable burden of preventable urogenital infections, sexually transmitted infections, and low circumcision rate-after an earlier study reported that a majority of Haitian medical providers were in need of and wanted newborn circumcision training...
2015: Global Pediatric Health
Mehmet Mutlu, Erol Erduran, Yakup Aslan
OBJECTIVE: This study aimed to determine the etiologic factors of acquired methemoglobinemia in infants younger than three months in our region. METHODS: This study was carried out retrospectively in infants with methemoglobinemia admitted to Karadeniz Technical University, Pediatric Clinic, during the period 2000-2009. Infants with methemoglobinemia were identified according to the medical records or ICD-10 code. RESULTS: Nine infants with acquired methemoglobinemia (8 male, 1 female) were included in the study...
June 5, 2011: Turkish Journal of Haematology: Official Journal of Turkish Society of Haematology
David J Chalmers, Vijaya M Vemulakonda
Pediatric urology spans the neonatal period through the transition into early adulthood. There are a variety of common pediatric urologic conditions that overlap significantly with pediatric surgery. This article reviews the pertinent pathophysiology of a few key disease processes, including the pediatric inguinal hernia and/or hydrocele, cryptorchidism, and circumcision. General surgeons may find themselves in the position of managing these problems primarily, particularly in rural areas that may lack pediatric subspecialization...
June 2016: Surgical Clinics of North America
Morten Frisch, Brian D Earp
In December of 2014, an anonymous working group under the United States' Centers for Disease Control and Prevention (CDC) issued a draft of the first-ever federal recommendations regarding male circumcision. In accordance with the American Academy of Pediatrics' circumcision policy from 2012 - but in contrast to the more recent 2015 policy from the Canadian Paediatric Society as well as prior policies (still in force) from medical associations in Europe and Australasia - the CDC suggested that the benefits of the surgery outweigh the risks...
May 19, 2016: Global Public Health
Yong-liang Ni, Hai-xin Wang, Yan Xu, Shou-bin Jiao
OBJECTIVE: To study the effects of skin wound induction gel on the glans scabbing rate, class-A wound healing rate, and wound healing time of circumcision for phimosis in pediatric patients. METHODS: We randomly assigned 48 six to thirteen years old children with phimosis to an experimental group (n = 25) and a control group (n = 23) to be treated by circumcision. After surgery, the patients in the experimental group received application of skin wound induction gel while those in the control group received that of povidone iodine only to the glans and incision...
March 2016: Zhonghua Nan Ke Xue, National Journal of Andrology
E C Diaz, J F Corcoran, E K Johnson
This video provides a case report of penis entrapment secondary to excessive skin removal during circumcision. It highlights the technical aspects of pediatric penile reconstruction using autologous split-thickness skin graft (STSG). Key points include: 1. Infection prevention is paramount and antibiotic prophylaxis is routine. 2. The usual harvest site for the STSG is the lateral thigh because of its source of glabrous skin and convenient proximity to the penis. The lateral thigh is also outside of the diapered area, which helps lessen postoperative pain and infectious risks...
June 2016: Journal of Pediatric Urology
R P Bonitz, M K Hanna
INTRODUCTION: Congenital penoscrotal webbing (PSW) is a condition that leads to penile shortening and is a common cause of delayed circumcision. While various techniques for PSW repair have been described, no comparative studies are currently available. OBJECTIVE: The goal of this study was to validate and critique three commonly utilized techniques for PSW repair. SUBJECTS AND METHODS: A retrospective chart review was performed on all patients who underwent repair for PSW, with or without concomitant surgical procedure, by a single surgeon (MKH) over a 7-year period...
June 2016: Journal of Pediatric Urology
Vikas Payal, Pramod Sharma, Vishnu Goyal, Rakesh Jora, Manish Parakh, Deepika Payal
BACKGROUND: Hemophilia is widely distributed all over the world, but little is known about its clinical profile in resource-limited regions. An insight into its clinical spectrum will help in the formulation of policies to improve the situation in these areas. AIMS: To study the clinical profile of hemophiliacs (age <18 years) in Jodhpur region and screen them for transfusion-transmitted infections. MATERIALS AND METHODS: A cross-sectional study conducted in the Department of Pediatrics, Umaid Hospital, Dr...
January 2016: Asian Journal of Transfusion Science
Boris Chertin, Stanislav Kocherov, Rami Binenboym, Yoav Gronovich, Izhak Tuchman, Leonid Chertin, Laurence Baskin
OBJECTIVES: We aimed to evaluate our experience with fenestrated sheet split-thickness skin grafts (STSGs) in the pediatric population. MATERIALS AND METHODS: We retrospectively studied a cohort of 17 children 2-18years old who underwent skin grafting owing to circumcision injuries (2 patients), traumatic penile injury (1) and after previous multiple hypospadias surgery (14). Fenestrated 0.012in sheet STSGs from thigh area (15 patients) and buttock area (2) were fashioned to resurface the denuded penis following reconstruction...
August 2016: Journal of Pediatric Surgery
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