{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T01:44:21Z","timestamp":1782956661266,"version":"3.54.5"},"reference-count":15,"publisher":null,"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,1,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>\n                      Circumcision is regarded as the most common surgical procedure world over. It is also perceived to be a simple and safe procedure; however, it could be fraught with major urological complications such as urethrocutaneous fistula (UCF). Repair of these fistulae poses a great reconstructive challenge to the paediatric surgeon\/urologist with varied outcomes.\n                      <jats:bold>Aim:<\/jats:bold>\n                      We seek to review the presentations, repair and outcome of post-circumcision UCFs managed in a tertiary centre.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods:<\/jats:title>\n                    <jats:p>This is a retrospective review of all the consecutive cases of repaired post-circumcision UCFs in Nnamdi Azikiwe University Teaching Hospital, Nnewi, South-East Nigeria, over a period of 9 years (January 2012\u2013December 2020). Data on demography, size of fistula, type of repair and outcome were retrieved from the Records Department and patients\u2019 case notes and were analysed using SPSS (version 22, Chicago, Illinois).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 22 boys had post-circumcision UCF repair within the period, and they were aged between 2 weeks and 108 months with a median age of 4 months at presentation and aged between 8 months and 144 months with a median age of 24 months at the time of surgery. Circumcisions were by freehand technique in 21 (95.5%). Nurses performed most of the circumcisions in 19 (86.4%), and most of the circumcisions were performed in private hospitals 7 (31.8%), maternity homes 3 (13.6%) and general hospitals in 10 (45.5%) each, respectively. Most 17 (77.3%) fistulae were coronal, and the size of defect ranged from 1 mm to 10 mm. The most commonly employed technique of repair was simple closure in 16 (72.2%). Meatal stenosis and re-fistulation occurred in 2 (9.1%) and 4 (18.2%), respectively. Only two (12.5%) required reoperation. There was no relationship between the size of defect and re-fistulation,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.377.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Majority of the Post-circumcision urethrocutaneous fistulae were from free hand technique of circumcisions . These were performed mostly by nurses in general, private hospitals and maternity homes. Hence, there is a need to ramp up training of providers of neonatal circumcision in our environment. Most UCF in children could be repaired with simple closure technique reinforced with dartos flap.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ajps.ajps_155_21","type":"journal-article","created":{"date-parts":[[2023,1,4]],"date-time":"2023-01-04T08:04:31Z","timestamp":1672819471000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Post-Circumcision Urethrocutaneous Fistulae"],"prefix":"10.67481","author":[{"given":"Jideofor Okechukwu","family":"Ugwu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Okechukwu Hyginus","family":"Ekwunife","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor Ifeanyichukwu","family":"Modekwe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy Uzoma","family":"Mbaeri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvester Okwuchukwu","family":"Obiechina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuka Abunike","family":"Ugwunne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":null,"reference":[{"key":"key-10.4103\/0189-6725.367104-1","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1186\/s12963-016-0073-5","article-title":"Estimation of country-specific and global prevalence of male circumcision","author":"Morris","year":"2016","journal-title":"Popul Health Metr"},{"key":"key-10.4103\/0189-6725.367104-2","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1186\/1471-2490-6-21","article-title":"Epidemiology of complications of male circumcision in Ibadan, Nigeria","author":"Okeke","year":"2006","journal-title":"BMC Urol"},{"key":"key-10.4103\/0189-6725.367104-3","doi-asserted-by":"crossref","first-page":"251","DOI":"10.4103\/0189-6725.172565","article-title":"Parental circumcision preferences and early outcome of plastibell circumcision in a Nigerian tertiary hospital","author":"Ekwunife","year":"2015","journal-title":"Afr J Paediatr Surg","ISSN":"https:\/\/id.crossref.org\/issn\/0189-6725","issn-type":"print"},{"key":"key-10.4103\/0189-6725.367104-4","doi-asserted-by":"crossref","first-page":"266","DOI":"10.4103\/1596-3519.59583","article-title":"Circumcision mishaps in Nigerian children","author":"Osifo","year":"2009","journal-title":"Ann Afr Med","ISSN":"https:\/\/id.crossref.org\/issn\/1596-3519","issn-type":"print"},{"key":"key-10.4103\/0189-6725.367104-5","unstructured":"World Health Organization. Male Circumcision: Global Trends and Determinants of Prevalence, Safety and Acceptability. Geneva: World Health Organization; 2008."},{"key":"key-10.4103\/0189-6725.367104-6","doi-asserted-by":"crossref","first-page":"145","DOI":"10.4103\/1119-3077.127422","article-title":"Urethrocutaneous fistula complicating circumcision in children","author":"Ikuerowo","year":"2014","journal-title":"Niger J Clin Pract","ISSN":"https:\/\/id.crossref.org\/issn\/1119-3077","issn-type":"print"},{"key":"key-10.4103\/0189-6725.367104-7","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1093\/tropej\/fmt020","article-title":"Complications of neonatal circumcision requiring surgical intervention in a developing country","author":"Ekenze","year":"2013","journal-title":"J Trop Pediatr"},{"key":"key-10.4103\/0189-6725.367104-8","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1097\/01.XPS.0000525973.41132.91","article-title":"Severity of malcircumcisions and circumcision-related complications in three tertiary health facilities in Southern Nigeria","author":"Okoro","year":"2018","journal-title":"Ann Pediatric Surg"},{"key":"key-10.4103\/0189-6725.367104-9","first-page":"44","article-title":"Experience with managing childhood urethrocutaneous fistula at Ibadan","author":"Takure","year":"2017","journal-title":"J West Afr Coll Surg","ISSN":"https:\/\/id.crossref.org\/issn\/2276-6944","issn-type":"print"},{"key":"key-10.4103\/0189-6725.367104-10","first-page":"246","article-title":"Circumcision-related complications in the male: Experience amongst the Igbo's of Southeast Nigeria","author":"Osuigwe","year":"2004","journal-title":"Afr J Urol"},{"key":"key-10.4103\/0189-6725.367104-11","doi-asserted-by":"crossref","first-page":"1343","DOI":"10.1053\/jpsu.2002.35005","article-title":"Revision of circumcision in children: Report of 56 cases","author":"Brisson","year":"2002","journal-title":"J Pediatr Surg"},{"key":"key-10.4103\/0189-6725.367104-12","doi-asserted-by":"crossref","unstructured":"Ekenze SO, Ugwu JO, Onumaegbu OO. Evaluation of neonatal circumcision training for resident doctors in a developing country. J Pediatr Urol 2015;11:6.e1-6.","DOI":"10.1016\/j.jpurol.2015.03.017"},{"key":"key-10.4103\/0189-6725.367104-13","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1186\/1471-2490-10-2","article-title":"Complications of circumcision in male neonates, infants and children: A systematic review","author":"Weiss","year":"2010","journal-title":"BMC Urol"},{"key":"key-10.4103\/0189-6725.367104-14","doi-asserted-by":"crossref","first-page":"71","DOI":"10.4103\/1117-6806.103106","article-title":"Surgically correctable morbidity from male circumcision: Indications for specialist surgical care in Lagos","author":"Ademuyiwa","year":"2012","journal-title":"Niger J Surg","ISSN":"https:\/\/id.crossref.org\/issn\/1117-6806","issn-type":"print"},{"key":"key-10.4103\/0189-6725.367104-15","doi-asserted-by":"crossref","first-page":"1","DOI":"10.22259\/2638-5228.0102001","article-title":"Giant \u201cdouble barreled\u201d urethrocutaneous fistula complicating neonatal circumcision \u2013 A case report","author":"Obi","year":"2018","journal-title":"Arch Urol"}],"container-title":["African Journal of Paediatric Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.4103\/ajps.ajps_155_21","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T00:49:46Z","timestamp":1782953386000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.4103\/ajps.ajps_155_21"}},"subtitle":["Presentations, Repairs and Outcomes in a Tertiary Centre"],"short-title":[],"issued":{"date-parts":[[2023,1,4]]},"references-count":15,"URL":"https:\/\/doi.org\/10.4103\/ajps.ajps_155_21","relation":{},"ISSN":["0189-6725"],"issn-type":[{"value":"0189-6725","type":"print"}],"subject":[],"published":{"date-parts":[[2023,1,4]]}}}