Circumcision in Hemophilia: A Multicenter Experience.
Child
Child, Preschool
Circumcision, Male
/ adverse effects
Follow-Up Studies
Hemophilia A
/ complications
Hemorrhage
/ complications
Hemostasis, Surgical
/ adverse effects
Humans
Infant
Male
Postoperative Complications
/ etiology
Prognosis
Retrospective Studies
Saudi Arabia
/ epidemiology
Severity of Illness Index
Journal
Journal of pediatric hematology/oncology
ISSN: 1536-3678
Titre abrégé: J Pediatr Hematol Oncol
Pays: United States
ID NLM: 9505928
Informations de publication
Date de publication:
01 2021
01 2021
Historique:
pubmed:
2
10
2020
medline:
7
4
2021
entrez:
1
10
2020
Statut:
ppublish
Résumé
Hemophiliac patients and their families have social pressure to undergo circumcision, despite the potential complications. The objective of this study was to report our experience in the circumcision of hemophilia patients. We included 35 patients with hemophilia who had circumcision in 3 centers from January 2010 to August 2019. Their age ranged between 0.3 months and 8 years. Hemophilia a was classified as mild (n=3), moderate (n=4), and severe (n=28). Patients received 2 doses of factor VIII concentrate 50μ/kg, 1 hour before the procedure and 12 hours after it. Four neonates were diagnosed with hemophilia after circumcision because of prolonged bleeding. Two patients with severe hemophilia A had bleeding after hospital discharge (6.5%). They received additional factor concentrate, and 1 patient had an extra stitch. Two patients had wound gaping (6.5%), and 1 patient had a wound infection (3.2%). Hemophilia is not an absolute contraindication for circumcision. Circumcision of hemophilic children should be performed under appropriate conditions in hemophilia centers. Bleeding is not frequent but could be serious.
Sections du résumé
BACKGROUND
Hemophiliac patients and their families have social pressure to undergo circumcision, despite the potential complications. The objective of this study was to report our experience in the circumcision of hemophilia patients.
MATERIALS AND METHODS
We included 35 patients with hemophilia who had circumcision in 3 centers from January 2010 to August 2019. Their age ranged between 0.3 months and 8 years. Hemophilia a was classified as mild (n=3), moderate (n=4), and severe (n=28). Patients received 2 doses of factor VIII concentrate 50μ/kg, 1 hour before the procedure and 12 hours after it.
RESULTS
Four neonates were diagnosed with hemophilia after circumcision because of prolonged bleeding. Two patients with severe hemophilia A had bleeding after hospital discharge (6.5%). They received additional factor concentrate, and 1 patient had an extra stitch. Two patients had wound gaping (6.5%), and 1 patient had a wound infection (3.2%).
CONCLUSION
Hemophilia is not an absolute contraindication for circumcision. Circumcision of hemophilic children should be performed under appropriate conditions in hemophilia centers. Bleeding is not frequent but could be serious.
Identifiants
pubmed: 33003145
doi: 10.1097/MPH.0000000000001960
pii: 00043426-202101000-00020
doi:
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
e33-e36Références
Alanis MC, Lucidi RS. Neonatal circumcision: a review of the world’s oldest and most controversial operation. Obst Gyneco Surv. 2004;59:379–382.
Massry SG. History of circumcision: a religious obligation or a medical necessity. J Nephrol. 2011;24:100–102.
Shittu OB, Shokunbi WA. Circumcision in haemophiliacs: the Nigerian experience. Haemophilia. 2001;7:534–536.
Introcaso CE, Xu F, Kilmarx PH, et al. Prevalence of circumcision among men and boys aged 14 to 59 years in the United States, national health and nutrition examination surveys 2005-2010. Sex Transm Dis. 2013;40:521–525.
Kavakli K, Kurugöl Z, Göksen D, et al. Should hemophiliac patients be circumcised. Pediatr Hematol Oncol. 2000;17:149–153.
Kavakli K, Aledort LM. Circumcision and hemophilia: a perspective. Haemophilia. 1998;4:1–3.
Tonbary YA, Elashry R, Mel ZS. Descriptive epidemiology of hemophilia and other coagulation disorders in mansoura, Egypt: retrospective analysis. Mediterr J Hematol Infect Dis. 2010;2:2010025.
Martinowitz U, Varon D, Jonas P. Circumcision in haemophilia: the use of fibrin glue for the local haemostasis. J Urol. 1992;148:855–857.
Blanchette VS, Sparling C, Turner C. Inherited bleeding disorders. Baillieres Clin Haematol. 1991;4:291–332.
Gallart MR, Estevez E, Bautista A, et al. Bipolar scissors circumcision is a safe, fast, and bloodless procedure in children. J Pediatr Surg. 2009;44:2048–2050.
Avanogmacr A, Celik A, Ulman I, et al. Safer circumcision in patients with haemophilia: the use of fibrin glue for local haemostasis. BJU Int. 1999;83:91–94.
Ozsoylu S. How hemophiliacs could be circumcised in developing countries. Pediatr Hematol Oncol. 2000;17:721–722.
Weiss HA, Larke N, Halperin D, et al. Complications of circumcision in male neonates. Infants and children: a systematic review. BMC Urol. 2010;10:1–13.
Perera CL, Bridgewater FH, Thavaneswaran P. Safety and efficacy of nontherapeutic male circumcision: a systematic review. Ann Fam Med. 2010;8:64–72.
O’Sullivan DC, Heal MR, Powell CS. Circumcision; how do urologists do it? Br J Urol. 1996;78:265–270.
Sasmaz I, Antmen B, Leblebisatan G, et al. Circumcision and complications in patients with haemophilia in southern part of Turkey: cukurova experience. Haemophilia. 2012;18:426–430.
Karaman L, Zulfikar B, Caskurlu T, et al. Circumcision in hemophilia: a cost-effective method using a novel device. J Pediatr Surg. 2004;36:1562–1565.
Sari N, Buyukunal SNC, Zulfikar B. Circumcision ceremonies at the Ottoman palace. J Pediatr Surg. 1996;31:920–924.
Elalfy MS, Elbarbary NS, Eldebeiky MS, et al. Risk of bleeding and inhibitor development after circumcision of previously untreated or minimally treated severe hemophilia A children. Pediatr Hematol Oncol. 2012;29:485–493.
Hermans C, Altisent C, Batorova A, et al. Replacement therapy for invasive procedures in patients with haemophilia: literature review, European survey and recommendations. Haemophilia. 2009;15:639–658.
Avanoğlu A, Çelik A, Ulman I, et al. Safer circumcision in patients with haemophilia: the use of fibrin glue for local hemostasis. BJU Int. 1999;83:91–94.
Yilmaz D, Akin M, Ay Y, et al. A single centre experience in circumcision of hemophilia patients: Izmir protocol. Haemophilia. 2010;16:889–891.
Rodriguez V, Titapiwatanakun R, Moir C, et al. To circumcise or not to circumcise? Circumcision in patients with bleeding disorders. Haemophilia. 2010;16:272–276.
American Academy of Pediatrics Task Force on Circumcision. Male circumcision. Pediatrics. 2012;130:e756–e785.