Rarely seen complications of circumcision, and their management
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Dosyalar
Tarih
2016
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Dinsel veya tıbbi nedenlerle uygulanan sünnet; glans penisi örten prepisyum adı verilen sünnet derisinin belirli şekil ve uzunlukta cerrahi yolla kesilerek alınması ve penis uç kısmının açığa çıkarılması işlemidir. Yaygın olarak uygulanan basit cerrahi bir işlem olarak kabul edilen sünnetin ülkelerin kayıt sistemleri ile ilgili olarak literatürde %50'ye varan erken ve geç dönem komplikasyon oranları bildirilmektedir.Bu çalışmada kliniğimize sünnet sonrası ortaya çıkan komplikasyonlar nedeniyle başvuran hastalara yapılan tedavi ve komplikasyonları azaltma yolları incelenmiştir.Gereç ve yöntemler: 2010-2013 yılları arasında kliniğimize erken dönem sünnet komplikasyonu nedeniyle başvuran olgular retrospektif olarak incelendi. Bunlardan majör komplikasyon olarak kabul edilen fazla cilt eksizyonu, cilt nekrozu ve glans total amputasyonu bulunan olgular çalışmaya dahil edilirken minör komplikasyonlardan kanama, hematom ve enfeksiyon gelişen olgular çalışmaya dahil edilmedi. Bulgular: Fazla cilt eksizyonu yapılan hastalarda tam kalınlıkta deri grefti ile onarım yapıldı. Cilt nekrozu debride edildikten sonra tam kat cilt defekti olan olgularda defektin büyüklüğüne göre primer veya tam kalınlıkta deri grefti ile onarım yapılırken parsiyel kayıplarda sekonder iyileşme beklendi. Glans amputasyonu olan olguda kasık flebi ile onarım yapıldı.Sonuç: Ülkemizde bildirilen sünnet komplikasyonlarının çoğundan, eğitimsiz kişilerce uygulanan sünnetler sorumludur. Buna toplu sünnet şölenleride eklendiğinde oran giderek artmaktadır. Cerrahi komplikasyonları dışında hepatit B/C, AİDS başta olmak üzere çeşitli hastalıkların bulaşmasına da zemin hazırlar. Sünnet, hastane koşullarında, uygun steril koşullarda, uzman kişilerce yapıldığında komplikasyon oranlarının azalabileceği cerrahi bir işlemdir. Ehil olmayan kişilerce yapıldığında çocuk, tekrarlayan psikososyal ve cerrahi travmalara maruz kalabilir
Objective: Circumcision, performed for religious or medical reasons is the procedure of surgical excision of the skin covering the glans penis, preputium in a certain shape and dimension so as to expose the tip of the glans penis. Short- and long- term complication rates of up to 50% have been reported, varying due to the recording system of different countries in which the procedure has been accepted as a widely performed simple surgical procedure. In this study, treatment procedures in patients presented to our clinic with complications after circumcision are described and methods to decrease the rate of the complications are reviewed. Material and metods: Cases that presented to our clinic between 2010 and 2013 with early complications of circumcision were retrospectively reviewed. Cases with acceptedly major complications as excess skin excision, skin necrosis and total amputation of the glans were included in the study, while cases with minor complications such as bleeding, hematoma and infection were excluded from the study. Results: Repair with full- thickness skin grafts was performed in patients with excess skin excision. In cases with skin necrosis, following the debridement of the necrotic skin, primary repair or repair with full- thickness graft was performed in cases where full- thickness skin defects developed and other cases with partial skin loss were left to secondary healing. Repair with an inguinal flap was performed in the case with glans amputation. Conclusion: Circumcisions performed by untrained individuals are to be blamed for the complications of circumcision reported in this country. The rate of complications increases during the “circumcision feasts” where multiple circumcisions were performed. This also predisposes to transmission of various diseases, primarily hepatitis B/C and AIDS. Circumcision is a surgical procedure that should be performed by specialists under appropriate sterile circumstances in which the rate of complications would be decreased. The child may be exposed to recurrent psychosocial and surgical trauma when it is performed by incompetent individuals
Objective: Circumcision, performed for religious or medical reasons is the procedure of surgical excision of the skin covering the glans penis, preputium in a certain shape and dimension so as to expose the tip of the glans penis. Short- and long- term complication rates of up to 50% have been reported, varying due to the recording system of different countries in which the procedure has been accepted as a widely performed simple surgical procedure. In this study, treatment procedures in patients presented to our clinic with complications after circumcision are described and methods to decrease the rate of the complications are reviewed. Material and metods: Cases that presented to our clinic between 2010 and 2013 with early complications of circumcision were retrospectively reviewed. Cases with acceptedly major complications as excess skin excision, skin necrosis and total amputation of the glans were included in the study, while cases with minor complications such as bleeding, hematoma and infection were excluded from the study. Results: Repair with full- thickness skin grafts was performed in patients with excess skin excision. In cases with skin necrosis, following the debridement of the necrotic skin, primary repair or repair with full- thickness graft was performed in cases where full- thickness skin defects developed and other cases with partial skin loss were left to secondary healing. Repair with an inguinal flap was performed in the case with glans amputation. Conclusion: Circumcisions performed by untrained individuals are to be blamed for the complications of circumcision reported in this country. The rate of complications increases during the “circumcision feasts” where multiple circumcisions were performed. This also predisposes to transmission of various diseases, primarily hepatitis B/C and AIDS. Circumcision is a surgical procedure that should be performed by specialists under appropriate sterile circumstances in which the rate of complications would be decreased. The child may be exposed to recurrent psychosocial and surgical trauma when it is performed by incompetent individuals
Açıklama
Anahtar Kelimeler
Üroloji ve Nefroloji, Circumcision, Complication, Treatment, Sünnet, Komplikasyon, Tedavi
Kaynak
Turkish Journal of Urology
WoS Q Değeri
Scopus Q Değeri
Q3
Cilt
42
Sayı
1
Künye
Ince, B., Dadaci, M., Altuntas, Z., Bilgen, F. (2016). Rarely seen complications of circumcision, and their management. Türk Üroloji Dergisi/turkish Journal of Urology, 42, 1, 12-15.
