Post Circumcision Corona Obliteration


Sody A Naimer and Bezalel Sivan. 2020. “Post Circumcision Corona Obliteration.” J Pediatr Urol, 16, 3, Pp. 389.e1-389.e5.


OBJECTIVE: Abnormal healing after neonatal ritual circumcision is a source of significant concern to patients' parents and their caregivers. This report presents a series of male infants who underwent ritual circumcision and subsequently developed obliteration of the normally distinct structure of the corona. METHODS: We report a case series of infants recruited from the community and a medical center. The compulsory inclusion criterion was absence of the normal landmarks of the glans penis with confirmed integrity of normal male genitalia. Illustrative cases are presented. The possible pathogenetic mechanisms leading to this condition are discussed. A literature search was conducted to discern whether this phenomenon has ever been previously reported. RESULTS: The eight cases we diagnosed were all otherwise normal. In one case, where we discovered use of an active substance on the circumcision wound, the condition persisted for an extended period but it resolved completely by 15 months of age. In all but one of the subjects the condition was transient and resolved over time. We could not reveal any previous publication on this topic. DISCUSSION: This noteworthy complication of circumcision raises debate whether it was previously existent, though unreported or a novel phenomenon. We postulate that contributing factors leading to tissue injury may possibly be injured tissue exposure to irritating substances, vascular compromise, the technique chosen to control bleeding or an idiosyncratic response to tissue trauma. More attention to the occurrence of this phenomenon is compulsory to collect more data and learn of its incidence and eventual impact. CONCLUSIONS: Obliteration of the corona, constitutes an unreported, rare albeit significant complication following circumcision. We recommend refraining from potentially inciting factors leading to this undesirable condition. More extensive experience with this disorder may enable us to employ preventive measures to eliminate it or at least provide reassurance wherever possible.