RESUMEN
Background: circumcision is the most common surgical intervention performed in non-medical settings. It is the most common but neglected procedure in our country. Barbers, quacks and other non-qualified persons perform circumcision by their own methods without proper sterilization and without knowing the consequences
Objectives: the objectives of our study were to determine different methods of circumcision and outcome of these methods in central Pakistan
Patients and Methods: this was an observational study conducted by the Department of Pediatric Surgery, Sheikh Zayed Hospital, Rahim Yar Khan. A total of 600 cases were included in this study and information was recorded on a pre-designed Performa. Attendants/parents having the best knowledge regarding circumcision of the child were interviewed. Related clinics were contacted to determine the methods of circumcision and sterilization techniques, where found necessary
Results: out of 600 cases 157 [26.17%] were circumcised in the 1st month of life [mean age: 10+/-3.5 days], 92 [15.33%] in first year [mean age: 7+/-2.4 months] and 351[58.5%] between one to twelve years of age [mean age: 6+/-2.33 years]. Regarding the personal who performed circumcision 110 [18.33%] cases were circumcised by the barbers, 139 [23.17%] by quacks, 210 [35%] by General Practitioners [GP] and 141 [23.5%] by surgeons [General and Pediatric Surgeons]. Regarding the methods of circumcision, bone cutter method was the commonest, 307 [51.17%], whereas, only 60 [10%] cases were circumcised by plastibell technique. Complications were more with barber method and less with plastibell technique. Under circumcision [too less prepuce is removed] is the commonest complication with barber method. Out of 110, the 11 children [10%] were under circumcised. In bone cutter method, out of 307 cases, 15 [4.87%] were under circumcised. No case was under circumcised with plastibell or open method. With barber method 06 cases [5.45%] got infected. They consulted doctors and were cured with antibiotics. Three [0.977%] cases were infected with bone cutter method. Bleeding occurred in 10 patients after bone cutter method and stitching was done. There was no bleeding with plastibell or open method
Conclusion: our study showed that a big proportion [41%] of male children are still getting circumcised by unskilled [quacks and barbars] operators and commonest method of circumcision was bone cutter method. There is a dire need to educate the people regarding age, methods of circumcision and their possible complications