Back to 2023 Abstracts

---

Office Gomco Circumcision is Safe in Patients Heavier than 5.5kg And/Or Older than 3 Months
Daniel A. Salevitz, MD¹, Carlos A. Villanueva Del Rio, MD².
¹Mayo Clinic - Arizona, Phoenix, AZ, USA, ²Phoenix Children's Hospital, Phoenix, AZ, USA.

Background: Studies have suggested that Gomco clamp circumcision should be avoided after 3 months of age and a weight cutoff of 5.1kg, however there are no universally accepted guidelines on the optimal patient age or weight. This study aims to compare outcomes of office circumcision within and outside these recommended patient parameters.Methods: This is a retrospective review of circumcisions performed by a single surgeon from July 2019 to March 2022. Demographics reviewed include age and weight at time of circumcision, gestational weeks at birth, postoperative bleeding, postoperative planned and unplanned visits, and postoperative interventions related to circumcision. “Active Bleeding” was defined as bleeding occurring after discharge from clinic, requiring intervention with pressure, sutures, or cautery. “All Bleeding” included Active Bleeding and cases where bleeding was controlled at home with pressure, bleeding stopped by the time of arrival at the clinic or emergency department, and immediate bleeding after circumcision controlled before discharge home.Results: A total of 773 Gomco circumcisions were performed. Most patients (603, 78%) had postoperative evaluation 2 weeks after circumcision. There were 575 patients (74%) less than 5.5kg and 199 (26%) over, Table 1. Six hundred and twenty patients (80%) were younger than 3 months and 153 (20%) were older, Table 2. After correcting for gestational age, 658 (85%) were younger than 3 months and 115 (15%) older. There was no statistically significant difference in Active Bleeding based on weight (p=0.3819), age (p=0.63), or corrected age (p=0.2798), Table 3. There was no statistically significant difference in All Bleeding based on weight (p=0.2072) or age (p=0.1586). There was a statistically significant difference (p=0.0258) in All Bleeding based on corrected age above or below 3 months. There was also a significant difference in unexpected visits based on weight (p=0.0258), age (p=0.0296), as well as corrected age (p=0.0131).Conclusions: Newborn Gomco clamp circumcision is safe in patients over 5.5kg and older than 3 months, with a less than 1% higher risk of bleeding, which in the current study was controlled without the use of general anesthesia or transfusions. Unexpected visits were more frequent for the patients outside the standard cutoffs for age and weight.
Table 1: Weight distribution of patients who underwent circumcision

Weight in Kg	Number
2	14
3	210
4	260
5	157
6	75
7	38
8	15
9	2
10	0
11	1
12	1

Table 2: Age distribution of patients who underwent circumcision

Age in months	Not corrected	Corrected for GA*
<1	281	333
1-3	339	325
3-6	130	96
>6	23	19

*GA = Gestational Age
Table 3: Active Bleeding and All Bleeding by weight and age

	Active Bleeding	p-value	All Bleeding	p-value
<5.5 kg	4 (0.7%)	0.3819	13 (2%)	0.2072
≥5.5 kg	3 (1.5%)		8 (4%)
<3 months	5 (0.8%)	0.6300	14 (2.2%)	0.1586
≥3 months	2 (1.3%)		7 (4%)
<3 months (corrected)	5 (0.8%)	0.2798	14 (2.1%)	0.0258
≥3 months (corrected)	2 (1.7%)		7 (6%)

---

Back to 2023 Abstracts