Abstract

Complications of Circumcision in Three Hospitals in Douala: Epidemiological, Clinical and Therapeutic Profile

Background: Description of the epidemiological, clinical, and therapeutic aspects of the complications of circumcision in three hospitals in the city of Douala. Methods: The work talks about the descriptive cross-sectional study for 4 months (from January to April 2021) with retrospective recruitment over 10 years (January 1st, 2011 to December 31st, 2020) in the surgery Departments of the Douala General Hospital, Douala Catholic Hospital Notre Dame de l’Amour and the Urology Department of Laquintinie Hospital of Douala. During this study period, all records of complications of circumcision that met the inclusion criteria have been included in this study. A pre-designed questionnaire has been used for data collection too. Confirmation of each case of complication was made by at least two urological surgeons. Results: A total of 131 patients have been admitted for complications of circumcision. Out of the 131 patients, the annual frequency of Circumcision complications has reached the level of 13.1 cases/year. Moreover, 29 patients were secondarily excluded from statistics analyzes because of incomplete files. Among the remaining 102 patients, 6 have had more than one complication. The average age has been 6.51 ± 5.74 years with extremes ranging from 1 month to 29 years. The most represented age group has been that of 0 to 5 years. The time elapsed before the consultation has been 1.86 years with extremes from 30 minutes to 16 years. The main reason for the consultation has been urine leakage through the urethral fistula (26.47%) followed by dysuria (24.51%). We found that 23.5% of patients have been circumcised outside the hospital. Paramedics have been responsible for the main complications (66.7%). The most common complication has been urethral fistula 27.5% followed by stenosis of the urethral meatus 24.5%. The study showed that 16.66% of patients required emergency treatment, among which compression bandages for 58.80%, hemostatic suture for 29.40%, antibiotics therapy for 17.60%, and blood transfusion for 5.90%, and urinary catheter for other 5.9%. A total of 95 patients received surgical repair. The clinical course has been satisfactory in 96.10% of cases and 3.90% had a reserved opinion. Conclusions: Circumcision which is known as the most practised surgical act almost all over the world must be performed by competent and trained staff to avoid the occurrence of complications.

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