COMPLICATION IN CIRCUMCISION: PENILE AMPUTATION

A SYSTEMATIC INDONESIAN CASE REPORT AND REVIEW

Yacobda Sigumonrong1, Michael Rulando2, Stephen Shei Dei Yang3, Nur Anindhawati4, Andry
Giovanni5, Arley Sadra Tellusa6, M Arwan Irzan7, Fusarina Mumpuni8

ABSTRACT

Introduction

Circumcision is one of the most commonly performed surgical procedures in everyday life.
Amputation of the penis is one of the circumcision’s complications which need immediate
treatment. We will discuss penile amputation as a complication of circumcision.

Methods

We searched literature on penis amputation cases in PubMed, Google Scholar, ScienceDirect,

and unpublished posts (thesis and abstract conferences). Inclusion criteria is cases of penis
amputation performed as circumcision’s complications that occur in Indonesia.

Results

There were 4 cases of penile amputations in subcoronal due to the circumcision performed by
general practitioners and nurses part were referred to the Adam Malik. Three cases of primary
repair of the penile stump and one case of a composite graft were performed. From literature
search, there are 9 studies with a total of 13 patients eligible for this review. All the patients were
previously undergone Guillotine circumcision technique, 7 cases located in sub-coronal (53.8%).
Rupture of urethra is occurred in all cases. Most of reconstruction techniques were primary closure
(3 cases/23.1%).
Conclusion

Amputation of the penis may occur because of ritual circumcision performed by untrained
paramedic. In our study rendering reimplantation is not possible and all complication in this study
was the result of Guillotine technique. Standardized education about circumcision technique may
results in less complication.

Keywords: penile amputation-circumcision-reconstruction