PB1251 - The experience of circumcision and it’s complications in adolescent and adult patients with severe hemophilia in southern part of Turkey: Cukurova experience

Background: Circumcision is the oldest and most frequent surgical procedure for hemophiliac patients in the world and especially in Turkey as is seen in the other Islamic countries because of religious and traditional pressures. The world health organization defines an adolescent as any person between ages 10 and 19. The social pressures are very strong in adolescent and adult hemophiliac patients ın our country.

Aims: In this study, we aim to report the experience of circumcision at Çukurova University and Acibadem Adana Hospital in total 49 adolescent and adult patients with hemophilia between 1994 and 2024.

Methods: We retrospectively reviewed medical records of 49 hemophiliac patients without inhibitors and 5 hemophiliac patients with inhibitors who had been circumcised. Before the year 2000, factor concentrates were given before and after circumcision for 6-7 days. After 2000, we used fibrin glue together with factor concentrates for only 3 days. By-passing agents were used for circumcision in hemophiliac patients with inhibitors.

Results: 49 patients with hemophilia age ranging from 10 years to 48 years were circumcised in our center under general anesthesia except for 3 patients who were given local anesthesia. Eight of 49 hemophilia patients (16,3%) without inhibitors had 5 mild and 3 moderate bleeding complications. A few patients had significant bleeding despite adequate factor replacement. Three of five hemophilia patients with inhibitors had mild and moderate bleeding complications.

Conclusion(s): Our experience showed that circumcision for patients with hemophilia should be carefully performed by surgeons together with pediatric hematologist under appropriate conditions in hemophilia centers which has comprehensive coagulation lab.