A Complication of Circumcision (letter)

Letters to the Editor

Surgical bivalving of the glans penis during non-therapeutic circumcision

To the editor: – a serious complication of circumcision unmentioned in the reference given by Lackey et al. (206:2318, 1968) is the surgical bivalving either by the dorsal or the ventral half of the glans penis. This is caused by inadequate placement of one limb of the scissors into the urethra rather than between the foreskin and the glans prior to performing either the dorsal or ventral slit. in the prepuce. These fortunately rare cases those with pinpoint openings in the phimotic foreskin with the glandular meatus just beneath the adhesions of the inner surface of the foreskin and glans penis are not reduced, the line of least resistance to placement of instrument is the urethra itself. Once the incision is made the glans penis is bivalved and the urethra laid open. In effect a second degree hypospadius has been produced.

While avoidance of this complication may seem quite elementary, it is true that circumcision is often performed by the most inexperienced physician. For this reason, we caution that the foreskin slit always be performed with the inner surface of the prepuce or the glandular meatus under direct vision.

Andrew J. McGowan, Jr. MD
 St. Vincent's Hospital & Medical Center
New York

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