Complications arising from ritual circumcision: pathogenesis and possible prevention.

Over a period of six years, five seriously ill infants were referred with complications arising from ritual circumcision performed by nonphysicians. Four infants developed systemic infections; in three of them, including one with early meningitis, there was septicemia. The common predisposing factor was an excessively tight dressing over an infected penile wound, leading to urinary retention, urinary tract infection and septicemia. In the fifth infant, the glans had been partially amputated and required a suture; a second dressing tightly applied to control the bleeding was removed without subsequent problems. To prevent the above complications, careful attention should be paid to the baby's voiding within the first 6 to 8 h after circumcision. In addition, it is suggested that all dressings should be removed, or at least replaced, on the day following circumcision, when the likelihood or primary hemorrhage has passed. These two simple maneuvers may avoid the above-mentioned complications.