We all want what is best for our children. Either for personal, medical or religious reasons, we sometimes choose to have our sons circumcised. When this procedure is performed by a doctor, we expect that they will perform the surgery within the accepted medical standard of care. Unfortunately, like with any type of surgery, this is not always the case and the surgery is incorrectly performed. Even worse, if a child's circumcision is incorrectly performed soon after birth, the revisionary surgery may bring with it the risks from anesthesia, which would not have needed if the surgery was performed correctly the first time.
As with any surgery, informed consent must be obtained by the physician prior to the surgery. Because the child cannot give consent, the consent should be obtained by their parent(s) or legal guardian(s). The doctor must provide the parents with the risks and benefits of the surgery, as well as alternatives so that they can make an informed decision prior to consenting to surgery. The doctor should also allow the parents to ask questions.
Possible Complications Of A Botched Circumcision
- Too much foreskin removed -Because the foreskin is attached to the Glans on the inner surface, it is possible to draw skin from the penile shaft up into a circumcision device, such as a clamp, and remove too much foreskin.
- Too little foreskin removed - "incomplete circumcision". When this occurs, the child may have a build up of normal skin cells, or smegma, underneath the extra skin, which leads to irritation, infection or adhesions of the skin to the head of the penis.
- Meatitis - redness at the opening of the penis, which may have a sore or scab on it. Passing urine may be painful.
- Amputation of the Glans - The Glans is the rounded part at the end of the penis. This complication has been reported where the clamps are improperly placed.The clamp is designed to allow the device to open only enough to allow the foreskin, and nothing else, into the area of compression, but if placed incorrectly with all or part of the glans admitted into this area, amputation will occur. If noticed quickly, and with the amputated Glans properly stored, a pediatric urologist may be able to reattach the Glans to the rest of the penis.
- Epispadias - This can occur when the slit to make the circumcision is inadvertently made into the urethra, thus opening the urethral tube (the tube from which urine exits the bladder). This condition can also occur genetically, but if not documented during the circumcision, may mean that a mistake was made during cutting.
- Chordee (curvature of the penis) -When chordee is not present at birth but develops as a complication of circumcision, it is thought to be due to uneven amounts of foreskin removal from the ventral (underside) and dorsal (upper side) surfaces.
- Infection - If the surgical site was not prepared properly or after-care was not performed correctly, an infection may occur.
- Death - While extremely rare, deaths due to circumcision have occurred.
How Is A Circumcision Revision Performed?
Once under anesthesia, a local anesthetic is applied near the penis to minimize post-procedure pain. Then the doctor removes the penile adhesions. If the adhesions are dense, they are cut and the extra skin is removed so there is no redundant skin left behind. The doctor makes sure there are no small vessels bleeding and small stitches are placed for healing. Sometimes a dressing is placed with bacitracin (an antibiotic) and the child is woken up and brought to a recovery room. The procedure usually does not require an overnight stay and the child will go home that same day.
Has Your Child Been A Victim Of A Botched Circumcision?
You and your child may have a claim for medical malpractice against the physician(s) who performed the surgery, as well as the hospital or clinic where it was performed. To know your rights and your options, please give me a call at (631) 938-6543 for a free consultation where we can review your child's surgery records and discuss your next steps.