Comparing Penile Problems in Circumcised vs. Uncircumcised Boys: Insights From a Large Commercial Claims Database With a Focus on Provider Type Performing Circumcision

• Published in: Journal of pediatric surgery 2024-11, Vol.59 (11), p.161614, Article 161614
• Main Authors: Fendereski, Kiarad, Horns, Joshua John, Driggs, Nathan, Lau, Glen, Schaeffer, Anthony J.
• Format: Article
• Language: English
• Subjects: Care provider; Case-Control Studies; Child; Child, Preschool; Circumcision; Circumcision, Male - adverse effects; Circumcision, Male - statistics & numerical data; Complication; Databases, Factual; Health systems research; Humans; Infant; Infant, Newborn; Male; Penile Diseases - epidemiology; Penile Diseases - etiology; Penis; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Retrospective Studies; Uncircumcised; United States - epidemiology
• ISSN: 0022-3468; 1531-5037; 1531-5037
• DOI: 10.1016/j.jpedsurg.2024.06.022

To compare penile problems in circumcised relative to uncircumcised boys, and to determine which providers performing the circumcision have fewer post-circumcision problems. CPT codes in the 2011–2020 MarketScan database were used to identify boys who had a circumcision. Uncircumcised control subjects of the same age, state of residence, and insurance type were selected. The primary outcome was a penile problem, defined as penis-specific infection, inflammation, and urethral stricture/stenosis, among others. The secondary outcomes were procedure-related complications limited to 28 days after circumcision, and whether post-circumcision problems varied by the clinician performing the procedure. ICD-9/10 diagnostic codes were used to identify these problems. We identified ∼850,000 cases and ∼850,000 matched controls. Overall, the rate of penile problems within the first five years of life was 1.7% in circumcised boys versus 0.5% in uncircumcised boys (p