Abstract
Amaç: Sünnet sonrası erken dönemde gelişebilen penil kanamaların kontrolünde, non-invaziv yöntem olan hafif-orta baskılı coban bandaj sargısının etkinliğini araştırmak. Hastalar ve Yöntem: Sünnet sonrası, akut dönemde gelişen penil kanama nedeniyle, Mayıs 2012 ile Ocak 2020 tarihleri arasında kliniğimize başvuran 112 çocuğun verileri retrospektif olarak incelenmiştir. Çocuklara, birinci basamak müdahale yöntemi olarak, hafif-orta baskılı coban bandajı uygulanmış ve 2 saatlik takipte kanamanın devam ettiği olgularda cerrahi müdahale yapılmıştır. Müdahale edilen çocuklar, olası cilt enfeksiyonu,cilt nekrozu,akut üriner retansiyon gelişimi ve penil skar gelişimi açısından incelenerek verileri kaydedilmiştir. Bulgular: Hastaların median yaşı 6(1-15) yıl ve median takip süreleri 5(1-12) aydır. Penil kanama nedeniyle, hafif-orta baskılı coban bandajı uygulanan çocuklardan 101(%90.2)’inde kanama tam olarak kontrol edilmişken, 11(% 9.8)’inde kanamanın devam etmesi nedeniyle cerrahi revizyon gerekli olmuştur. Çocukların 8(%7.1)’inde topikal antibiyotik tedavisiyle düzelen yüzeyel cilt enfeksiyonu gelişirken, sadece 6(%5.4)’sında uzun dönemde kozmetik açıdan rahatsız edici cilt skarı geliştiği tesbit edilmiştir. Sonuç: Sünnet sonrası, akut dönemde gelişen penil kanamaların kontrolünde, hafif-orta baskılı coban bandajı cerrahi müdahale gerekliliğini ciddi oranda azaltabilen, etkili, non-invaziv ve poliklinik şartlarında kolay uygulanabilir bir yöntemdir.
References
- 1. Prabhakaran S,Ljuhar D,Coleman R,Nataraja RM. Circumcision in the paediatric patient: a review of indications,technique and complications. J Paediatr Child Health. 2018;54:1299-1307.
- 2. Sivaslı E, Bozkurt AI, Ceylan H,Coskun Y. Gaziantep bölgesindeki anne ve babaların sünnet ile ilgili bilgi,tutum ve davranışları. Çocuk Sagliği ve Hastaliklari Dergisi. 2003;46:114-118.
- 3.Ekenze SO, Ezomike UO. Complications of neonatal circumcision requiring surgical intervention in a developing country.J Trop Pediatr. 2013;59:292-297.
- 4.Bailey RC, Moses S, Parker CB, et al. Male circumcisionfor HIV prevention in young men in Kisumu, Kenya: a randomised controlled trial. Lancet. 2007;369:643–656.
- 5.Morris BJ, Bailis SA, Wiswell TE. Circumcisionrates in the United States: rising or falling? What effect might the new affirmative pediatric policy statement have? Mayo ClinProc. 2014;89(5):677–686.
- 6.WHO-UNAIDS. Male Circumcision: Global Trendsand Determinants of Prevalence, Safetyand Acceptability. Geneva, Switzerland: World Health Organization; 2008; Section 3:22-26.
- 7.Krill AJ, Palmer LS, Palmer JS. Complications of circumcision. Scientific World Journal. 2011;11:2458-68.
- 8. Özdemir E. Significantly increased complication risks with mass circumcisions. Br J Urol1997;80:136-39.
- 9.Telli O,SoygürT.Sünnet Komplikasyonları.Pediatrik Üroloji Bülteni 2018;1:5-8.
- 10. Weiss HA, Larke N, Halperin D, Schenker I. Complications of circumcision in male neonates,infants and children: a systematic review. BMC Urol2010;10:2.
- 11.Leitch IOW. Circumcision: a continuingenigma. Australian Pediatrics Journal 1970; 6: 59.
- 12.Smey P. Penile denudation injuries after circumcision. J Urol 1985; 134: 1220.
- 13.Ferhatoglu MF, Kartal A, Gurkan A. Evaluation of Male Circumcision: Retrospective Analysis of One Hundred and Ninety-eight Patients. Cureus. 2019 27;11:4555.
- 14.Cecen K,Kocaaslan R,Karadag MA,Demir A,Cebeci O,Uslu M. 2220 sünnet olgusunda uzman doktorların kompliksyonlarının incelenmesi.Kocaeli Tıp Dergisi 2014;1:11-14.
- 15.Wiswell TE,Geschke DW. Risks from circumcision during the first month of life compared with those for uncircumcised boys. Pediatrics. 1989;83:1011-5.
- 16. Williams N, Kapila L. Complications of circumcision. Br J Surg. 1993 Oct;80(10):1231-6.
- 17.Heras A, Vallejo V, Pineda MI, Jacobs AJ, Cohen L. Immediate Complications of Elective Newborn Circumcision. Hosp Pediatr. 2018;8:615-619.
- 18.Berman W. Urinary retention due to ritual circumcision. Pediatrics 1975; 56: 621.
Abstract
Objective: To investigate the effectiveness of mild-modarate pressure coban bandage dressing, which is a non-invasive method, in the control of penile bleeding that may develop in the early period after circumcision. Materials and Methods: The data of 112 children who presented to our clinic between May 2012 and January 2020 due to penile bleeding in the acute period after circumcision were retrospectively analyzed. A mild-moderate pressure coban bandage was applied to the children as a first-line intervention method, and surgical intervention was performed in cases where bleeding continued after 2 hours of follow-up. Children were examined for possible skin infection, skin necrosis, development of acute urinary retention and penile scar development, and their data were recorded. Results: The median age of the patients was 6 (1-15) years and the median follow-up period was 5 (1-12) months. While bleeding was fully controlled in 101 (90.2%) of the 112 children who were treated with mild-modarate pressure coban bandage due to penile bleeding, surgical intervention was required in 11 (9.8%) of them because of the continuing bleeding. While superficial skin infection developed in 8 (7.1 %) of the children, which improved with topical antibiotic treatment, it was found that only 6 (5.4%) developed cosmetically disturbing skin scar in the long term. Conclusion: In the control of penile bleeding in the acute period after circumcision, a mild-moderate pressure coban bandage is an effective, non-invasive method that can be applied in polyclinic conditions, which can significantly reduce the need for surgical intervention.
References
- 1. Prabhakaran S,Ljuhar D,Coleman R,Nataraja RM. Circumcision in the paediatric patient: a review of indications,technique and complications. J Paediatr Child Health. 2018;54:1299-1307.
- 2. Sivaslı E, Bozkurt AI, Ceylan H,Coskun Y. Gaziantep bölgesindeki anne ve babaların sünnet ile ilgili bilgi,tutum ve davranışları. Çocuk Sagliği ve Hastaliklari Dergisi. 2003;46:114-118.
- 3.Ekenze SO, Ezomike UO. Complications of neonatal circumcision requiring surgical intervention in a developing country.J Trop Pediatr. 2013;59:292-297.
- 4.Bailey RC, Moses S, Parker CB, et al. Male circumcisionfor HIV prevention in young men in Kisumu, Kenya: a randomised controlled trial. Lancet. 2007;369:643–656.
- 5.Morris BJ, Bailis SA, Wiswell TE. Circumcisionrates in the United States: rising or falling? What effect might the new affirmative pediatric policy statement have? Mayo ClinProc. 2014;89(5):677–686.
- 6.WHO-UNAIDS. Male Circumcision: Global Trendsand Determinants of Prevalence, Safetyand Acceptability. Geneva, Switzerland: World Health Organization; 2008; Section 3:22-26.
- 7.Krill AJ, Palmer LS, Palmer JS. Complications of circumcision. Scientific World Journal. 2011;11:2458-68.
- 8. Özdemir E. Significantly increased complication risks with mass circumcisions. Br J Urol1997;80:136-39.
- 9.Telli O,SoygürT.Sünnet Komplikasyonları.Pediatrik Üroloji Bülteni 2018;1:5-8.
- 10. Weiss HA, Larke N, Halperin D, Schenker I. Complications of circumcision in male neonates,infants and children: a systematic review. BMC Urol2010;10:2.
- 11.Leitch IOW. Circumcision: a continuingenigma. Australian Pediatrics Journal 1970; 6: 59.
- 12.Smey P. Penile denudation injuries after circumcision. J Urol 1985; 134: 1220.
- 13.Ferhatoglu MF, Kartal A, Gurkan A. Evaluation of Male Circumcision: Retrospective Analysis of One Hundred and Ninety-eight Patients. Cureus. 2019 27;11:4555.
- 14.Cecen K,Kocaaslan R,Karadag MA,Demir A,Cebeci O,Uslu M. 2220 sünnet olgusunda uzman doktorların kompliksyonlarının incelenmesi.Kocaeli Tıp Dergisi 2014;1:11-14.
- 15.Wiswell TE,Geschke DW. Risks from circumcision during the first month of life compared with those for uncircumcised boys. Pediatrics. 1989;83:1011-5.
- 16. Williams N, Kapila L. Complications of circumcision. Br J Surg. 1993 Oct;80(10):1231-6.
- 17.Heras A, Vallejo V, Pineda MI, Jacobs AJ, Cohen L. Immediate Complications of Elective Newborn Circumcision. Hosp Pediatr. 2018;8:615-619.
- 18.Berman W. Urinary retention due to ritual circumcision. Pediatrics 1975; 56: 621.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Internal Diseases |
| Journal Section | Orijinal Articles |
| Authors | |
| Publication Date | June 20, 2021 |
| Submission Date | November 30, 2020 |
| Published in Issue | Year 2021 Volume: 15 Issue: 2 |
English or Turkish manuscripts from authors with new knowledge to contribute to understanding and improving health and primary care are welcome.