When circ's go bad...

Specialties Ob/Gyn

Published

Has anyone seen a circ go really bad? I saw one today where the doc took too much foreskin off and the skin on the shaft ended up "degloving" from the fascia underneath. A urologist had to come in and do "damage control." The people I've talked with say they've never seen anything like this happen before.

We only have one ped does circs in the hospital, and most parents don't ask about it. As we have at least 50% hispanic population, I don't think even 40% of the babies are circed.

Anyone remember the story from at least 30 or 40 years ago about twins being circed, the doc was using something new to cauterize, and bungled the job on one baby. I think the doc severed the end of his member. To make matter worse, the parents were talked into castrating the baby and raising him as a girl.

As an adult, the boy decided he was really male, and later wrote a book.

I read that book. Sadly, as noted, both he and his brother killed themselves. If you read the book, the doctor who took care of their psychological needs was and is a very sick man. The man who ended up being raised as a girl ended up very angry at the doctor who made he and his brother do very weird things during their sessions with him. Dr. Money should be removed from his positon at John's Hopkins and thoroughly discredited - but there he sits. :angryfire

I've read the book over a couple of times . .. he forgave his parents in the end but it would have been better if he had been raised the sex he was.

It is a good book but very sad.

steph

Specializes in NICU.

Steph, do you remember the title of the book? I haven't read it yet, and I could add it to my stack to read while I'm off sick.

Mimi

Steph, do you remember the title of the book? I haven't read it yet, and I could add it to my stack to read while I'm off sick.

Mimi

Yeah, it is sitting right here . .. "As Nature Made Him: The Boy Who Was Raised As A Girl" by John Colapinto.

steph

Specializes in NICU.
And this is amazingly unethical. The standard of care is the same, insurance or no insurance. Did you (if you worked here) or anyone else at that hospital have the cojones to report this? It's called advocating for your patient. By being silent, you're complicit in the act.

Jeez, give me a break here, I was just telling the story of a circ gone bad!!! I was doing my very first rotation as a junior nursing student, it was the second day of clinical, and I was petrified. We hadn't yet learned about circumcision in class yet, and all I was doing was helping soothe the baby during the procedure. I had no clue what was normal! Only when I commented about the baby being in pain as they examined him did the docs informed me that he had no insurance so they didn't use EMLA on him. I did point it out to my instructor that I thought it was totally wrong to provide pain relief to some infants but not others, so yes I did report it to someone. It was an absolute pit of a hospital, and I haven't set a foot in there since my clinicals ended.

Jeez, give me a break here, I was just telling the story of a circ gone bad!!! I was doing my very first rotation as a junior nursing student, it was the second day of clinical, and I was petrified. We hadn't yet learned about circumcision in class yet, and all I was doing was helping soothe the baby during the procedure. I had no clue what was normal! Only when I commented about the baby being in pain as they examined him did the docs informed me that he had no insurance so they didn't use EMLA on him. I did point it out to my instructor that I thought it was totally wrong to provide pain relief to some infants but not others, so yes I did report it to someone. It was an absolute pit of a hospital, and I haven't set a foot in there since my clinicals ended.

Lighten up - you did the right thing! You spoke up!. The surgeon is the one who was unethical, not you. Hopefully someone further up the line took notice. Funny that a nursing student on their 2nd day of clinical notices the problem that everyone else is ignoring.

Specializes in ICU, step down, dialysis.

JWK, are you a nurse?

Close but no cigar - your original stat was regarding the mortality rate from infant circs compared to penile cancer. This statement from the AAP doesn't address that.

That would leave out about 98% of the work that plastic surgeons do every day.

I think the main point is that it's up to the parents to decide what is or is not appropriate in this situation - not you, not the RN in the nursery, not me. Whether you agree with it or not, it's a perfectly legal procedure nationwide, and I'd guess you'd have a hard time restricting it.

And this is amazingly unethical. The standard of care is the same, insurance or no insurance. Did you (if you worked here) or anyone else at that hospital have the cojones to report this? It's called advocating for your patient. By being silent, you're complicit in the act.

Specializes in NICU.
Lighten up - you did the right thing! You spoke up!. The surgeon is the one who was unethical, not you. Hopefully someone further up the line took notice. Funny that a nursing student on their 2nd day of clinical notices the problem that everyone else is ignoring.

I don't need to lighten up because I wasn't overreacting. Your post was pretty harsh.

Did you (if you worked here) or anyone else at that hospital have the cojones to report this? It's called advocating for your patient. By being silent, you're complicit in the act.
I don't need to lighten up because I wasn't overreacting. Your post was pretty harsh.

You answered the question - I asked if you or anyone else reported it. You reported it. You did the right thing.

I'll stand by my opinion that those who ignore sub-standard unethical care are just as complicit as those actually providing that care. It doesn't matter if it's a jerk that doesn't use anesthesia on non-insured patients (a lawyer would have a field day with that one) or a surgeon who is a risk to their patients just by stepping in the OR or a whole group of screwups in a Florida hospital that amputated the wrong leg on a patient.

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

:angryfire

That was just in the news last year. Sadly, the victim committed suicide last year. Source:

http://www.cbc.ca/news/background/reimer/

that is simply horrible. how tragic. the ignorance...

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

jwk are you a nurse? just curious.

Has anyone seen a circ go really bad? I saw one today where the doc took too much foreskin off and the skin on the shaft ended up "degloving" from the fascia underneath. A urologist had to come in and do "damage control." The people I've talked with say they've never seen anything like this happen before.

You'll get to know who does good circs and who doesn't. We had a couple of docs like that who do lousy circs. Thank God they have let others do them for them now. Yes, they do bleed on occasion. We have adrenalin for that problem that we use if necessary. If you do get a bleeder, try NOT to dislodge the clot that forms.

I've never known a man who has needed a circ later in life. You don't hear about this in places where non-circumsized is the norm, so I am somewhat skeptical that this is really medically necessary all that often.

MY brother and three of my cousins had phimosis and had to be circumcised later in life. My family is from Brazil and there where isn't common for children to be circumcised it's very common to see older children or grown man being circumcised due to infections related to the inability of the foreskin to retract and such. I believe that here in the US we don't see that very much because most men are circumcised. But believe or nor it happens more often that you can imagine in other countries where most men aren't circumcised.

Lt Nurse

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