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Outcomes of Complex Circumcisions for Pre-cancerous and Cancerous Penile Lesions at a Tertiary Referral Centre: A Retrospective Cohort Study
Elmousili, M. Kafagi, A. H. Abdullah, M. Christopoulos, P. Lau, M. Parnham, A. Sangar, V.
Elmousili, M.
Kafagi, A. H.
Abdullah, M.
Christopoulos, P.
Lau, M.
Parnham, A.
Sangar, V.
Abstract
OBJECTIVE: This study aimed to evaluate the complication rates of complex circumcisions performed for penile cancer, penile intra-epithelial neoplasia (PeIN) and severe lichen sclerosus, and to identify any predictors of post-operative complications. PATIENTS AND METHODS: A retrospective cohort study was conducted at a tertiary urology referral centre. Records of 191 male patients who underwent complex circumcisions between 2014 and 2020 were reviewed. Complex circumcision was defined as circumcision for cancerous or pre-cancerous lesions, condyloma or severe lichen sclerosus with >50% adherence to the glans. Patient demographics, indications, surgical variables and complications were analysed. Complications were graded using the Clavien-Dindo classification. RESULTS: The overall complication rate was 11%. The most common complications were infection (n = 5) and altered glans sensation (n = 5). Consultant-performed procedures had a significantly higher complication rate (14%) compared to those performed by trainees (2.3%) (p = 0.05), likely reflecting case complexity. No statistically significant associations were found between complications and patient age, indication, cancer stage or grade, type of circumcision or suture technique. All complications were Clavien-Dindo Grade I or II, and there were no readmissions. CONCLUSION: Complex adult circumcisions carry a modest complication risk, particularly in oncological cases. While consultant-led procedures had higher complication rates, this likely reflects the referral of more complex pathology. These findings provide a UK-based evidence base for consenting patients undergoing circumcision for malignant or pre-malignant indications.
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Date
2025
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Citation
Elmousili M, Kafagi AH, Abdullah M, Christopoulos P, Lau M, Parnham A, et al. Outcomes of Complex Circumcisions for Pre-cancerous and Cancerous Penile Lesions at a Tertiary Referral Centre: A Retrospective Cohort Study. Cureus. 2025 Aug;17(8):e89893. PubMed PMID: 40799668. Pubmed Central PMCID: PMC12341482. Epub 2025/08/13. eng.