{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T10:54:25Z","timestamp":1774263265247,"version":"3.50.1"},"reference-count":0,"publisher":"Canadian Urological Association Journal","issue":"7-8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CUAJ"],"abstract":"<jats:p>Introduction: Notwithstanding the recommendations from the\u00a0Canadian Pediatric Association and the American Academy of\u00a0Pediatrics on the indications for neonatal circumcision, this procedure is still common in North America and throughout the world.\u00a0Our purpose is not to argue whether this procedure should be\u00a0done, but rather to examine who is doing it, their training, how it\u00a0is performed and how can we prevent unsatisfactory results and\u00a0complications. The objective is to identify what fields of knowledge require improvement and then design a teaching module to\u00a0improve the outcomes of neonatal circumcision.Methods: A 19-question cross-sectional survey, including a visual\u00a0identification item, was submitted to 87 physicians who perform\u00a0neonatal circumcisions in Southwestern Ontario, Canada. To\u00a0improve our response rate, study subjects were contacted in a\u00a0variety of ways, including mail and fax and telephone. Once the\u00a0survey was completed, we produced a surgical technique training\u00a0video on using the Gomco clamp and the Plastibell techiques. A\u00a0knowledge dissemination workshop was held with survey participants to discuss contraindications and the use of anesthesia and\u00a0management of complications of neonatal circumcision and to\u00a0evaluate the surgical technique training video. A 6-month followup questionnaire was completed to determine the impact of the\u00a0teaching course on participants\u2019 daily practice.Results: In total, we received 54 responses (62% response rate).\u00a0From these, 46 (85%) were family doctors and pediatricians, while\u00a0the remaining 8 (15%) were pediatric general surgeons and urologists. The circumcisions were carried out with the Gomco clamp\u00a035 (63%) and the Plastibell 21 (37%). No respondent admitted to\u00a0learning the procedure through a structured training course. Of\u00a0the non-surgeons, 19 (43%) learned to perform a circumcision\u00a0from a non-surgeon colleague. A little over a third of the participants (17, 31%) were happy to perform a circumcision in a child\u00a0born with a concealed penis, where circumcision is contraindicated. With respect to the early complications post-circumcision, 8\u00a0(100%) surgeons versus 29 (63%) non-surgeons felt comfortable\u00a0dealing with bleeding (p = 0.046). In total, 7 (88%) surgeons versus 16 (35%) non-surgeons were comfortable dealing with urinary\u00a0retention (p = 0.01). Also, 8 (100%) surgeons versus 24 (52%)\u00a0non-surgeons were comfortable dealing with a wound dehiscence\u00a0(p = 0.02). Moreover, 6 (75%) surgeons and 5 (10%) non-surgeons\u00a0were comfortable managing meatal stenosis (p &lt; 0.01). Five (63%)\u00a0surgeons versus 15 (33%) non-surgeons were confident in dealing\u00a0with a trapped penis post-circumcision (p = 0.24).Conclusions: Our survey findings indicate that most physicians performing neonatal circumcisions in our community have received\u00a0informal and unstructured training. This lack of formal instruction\u00a0may explain the complications and unsatisfactory results witnessed in our pediatric urology practice. Many practitioners are not\u00a0aware of the contraindications to neonatal circumcision and most\u00a0non-surgeons perform the procedure without being able to handle\u00a0common post-surgical complications. Based on our survey findings,\u00a0we planned and carried out a formal training course to address\u00a0these issues.<\/jats:p>","DOI":"10.5489\/cuaj.200","type":"journal-article","created":{"date-parts":[[2013,11,21]],"date-time":"2013-11-21T10:14:40Z","timestamp":1385028880000},"page":"260","source":"Crossref","is-referenced-by-count":16,"title":["Are Physicians  Performing Neonatal  Circumcisions Well Trained?"],"prefix":"10.5489","volume":"7","author":[{"given":"J.","family":"DeMaria","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Abdulla","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Pemberton","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Raees","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L.H.","family":"Braga","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3456","published-online":{"date-parts":[[2013,8,19]]},"container-title":["Canadian Urological Association Journal"],"original-title":[],"link":[{"URL":"http:\/\/www.cuaj.ca\/index.php\/journal\/article\/viewFile\/200\/1284","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/www.cuaj.ca\/index.php\/journal\/article\/viewFile\/200\/1284","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2017,9,11]],"date-time":"2017-09-11T11:52:04Z","timestamp":1505130724000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.cuaj.ca\/index.php\/journal\/article\/view\/200"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,8,19]]},"references-count":0,"journal-issue":{"issue":"7-8","published-online":{"date-parts":[[2013,8,19]]}},"URL":"https:\/\/doi.org\/10.5489\/cuaj.200","relation":{},"ISSN":["1920-1214","1911-6470"],"issn-type":[{"value":"1920-1214","type":"electronic"},{"value":"1911-6470","type":"print"}],"subject":[],"published":{"date-parts":[[2013,8,19]]}}}