For practioners who are asked to perform circumcisions, it it critical to know when to say "no". Although uncommon individually, there are several conditions that are considered contraindications to circumcision, so it is not unusual for a physician with a busy practice to have several patients who would not be candidates for routine neonatal cirucumcision.
Please note: this resource is not an exhaustive review. Conditions other than those noted below may also preclude routine circumcision. When in doubt, a pediatric urologist should be consulted and the procedure deferred until it is determined to be safe.
Anatomic Contraindications to Neonatal Circumcision
- Hypospadias
- Chordee
- Penile Torsion
- Webbed Penis
- Buried Penis
- Urethral Hypoplasia
- Epispadias
- Ambiguous Genitalia (including bilateral cryptorchidism or micropenis)
Medical Contraindications to Neonatal Circumcision
- Any current illness or medical condition that requires monitoring
- Age less than 12 - 24 hours
- Known bleeding diathasis (e.g. hemophilia or thrombocytopenia)
- Disorders of the skin or connective tissue that would impair normal healing
Other Contraindications
- Informed parental consent has not been obtained
REFERENCES
- AAP, "Circumcision Policy Statement". Peds, Mar 103(3):686-693, 1999.
- Elder, J. "Circumcision". BJU Int, Jun 99(6): 1553-1564, 2007.
- Eroglu, E, et al. "Buried penis after newborn circumcision". J Urol, Apr 181(4): 1841-1843, 2009.
- Hutcheson, JC. "Male neonatal circumcision: indications, controversies, and complications". Urol Clin N Amer, Aug 31(3): 461-467, 2004.
- Lerman, SE and JC Liao. "Neonatal circumcision". Ped Clin N Amer, 48(6):1539-1557, 2001.
- Niku, SD, et al. "Neonatal circumcision". Uro Clin N Amer, 22(1): 57-65, 1995.
JAbyMD, 5-09
