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By 30 days the wound had healed completely in 99% and by 3 months 100%.By one month all had returned to normal activities.For example, excessive bleeding (23% versus 1.2%), infection (14% versus 0.5%), hematoma (6% versus 0.2%).The rate of complications for boys in Iran mostly operated on by traditional circumcisers was 7.4%, including excessive residual foreskin (3.6%), excessive skin removed (1.3%), meatal stenosis (0.9%), granaloma (0.7%), penile rotation (0.5%), secondary cordee (0.2%) [Yegane et al., 2006].The findings offered promise for scaling up of medical circumcision alongside traditional initiation into manhood.Deficiencies in training and resources in settings such as Africa need to be addressed and new methods such as use of simple, safe devices [Kim & Goldstein, 2009].

Of these, the most common were postoperative bleeding (0.4%) or infection (0.4%), followed by wound disruptions (0.3%), delayed healing (0.2%), and swelling at the incision site (0.1%) [Bailey et al., 2007; Krieger et al., 2007].In the Ugandan RCT the rate of moderate adverse events was 3% and severe 0.2% [Gray et al., 2007a], i.e., 1 event per 500 surgeries.The severe events included 1 wound infection, 2 hematomas that required re-exploration and ligation of bleeding vessels, one wound disruption due to an external cause, and one postoperative herpetic ulceration [Gray et al., 2007a].At 3 days 48% reported no pain, 52% mild pain, and none had severe pain.By the 8 day visit 89% reported no pain and 11% mild pain.Even after operator training, incorrect instrument use occurred and complications remained unacceptably high [Peltzer et al., 2008].In this study of the Xhosa in South Africa, 88% of the adolescents (mean age 18.7) had already started to have sex before being circumcised, putting them at risk.In Turkey, circumcision of boys aged 1.5–14 (mean 7 years) by unlicensed traditional circumcisers led to a far greater number of complications (85%) compared with those performed by surgeons in a sterile hospital setting (2.6%).The boys who experienced complications were aged 2–13 (mean 6) [Atikeler et al., 2005].In the South African RCT, 3.8% had an adverse event as follows: pain (0.8%), excessive bleeding (0.6%), infection (0.2%), swelling or hematoma (0.6%), problems with appearance (0.6%), damage to the penis (0.3%), insufficient skin removed (0.3%), delayed wound healing (0.1%), anesthesia-related event (0.06%) [Auvert et al., 2005].At 21 months follow-up the following were seen in 1.0%: problem with urinating (0.3%), dissatisfaction with the appearance of the penis (0.4%), mild or moderate erectile dysfunction (0.4%).

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