Evidence map›Paper›PMID 39084960›Full record

ArticleJournal of pediatric surgery2024

Comparing Penile Problems in Circumcised vs. Uncircumcised Boys: Insights From a Large Commercial Claims Database With a Focus on Provider Type Performing Circumcision.

Kiarad Fendereski, Joshua John Horns, Nathan Driggs, Glen Lau, Anthony J Schaeffer

Abstract readComparative Study
In one paragraph

Article in Journal of pediatric surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Kiarad FendereskiDivision of Urology, Department of Surgery, University of Utah School of Medicine, Salt Lake City, UT, 84132, USA.
Joshua John HornsDivision of Urology, Department of Surgery, University of Utah School of Medicine, Salt Lake City, UT, 84132, USA; Surgical Population Analysis Research Core, Department of Surgery, University of Utah School of Medicine, Salt Lake City, UT, 84132, USA.
Nathan DriggsSurgical Population Analysis Research Core, Department of Surgery, University of Utah School of Medicine, Salt Lake City, UT, 84132, USA.
Glen LauDivision of Urology, Department of Surgery, University of Utah School of Medicine, Salt Lake City, UT, 84132, USA; Intermountain Primary Children's Hospital, Salt Lake City, UT, 84113, USA.
Anthony J SchaefferDivision of Urology, Department of Surgery, University of Utah School of Medicine, Salt Lake City, UT, 84132, USA; Intermountain Primary Children's Hospital, Salt Lake City, UT, 84113, USA. Electronic address: anthony.schaeffer@hsc.utah.edu.

Funding

The Utah-Cohort Of Postnatally persistent Antenatal Hydronephrosis (U-COPAH)K08DK119535 · NIDDK · UNIVERSITY OF UTAH · PI SCHAEFFER, ANTHONY J · 2020 to 2024
$836k
NIDDK NIH HHS K08 DK119535
6 · The paper itself

Abstract

objectivesTo compare penile problems in circumcised relative to uncircumcised boys, and to determine which providers performing the circumcision have fewer post-circumcision problems.

methodsCPT codes in the 2011-2020 MarketScan database were used to identify boys who had a circumcision. Uncircumcised control subjects of the same age, state of residence, and insurance type were selected. The primary outcome was a penile problem, defined as penis-specific infection, inflammation, and urethral stricture/stenosis, among others. The secondary outcomes were procedure-related complications limited to 28 days after circumcision, and whether post-circumcision problems varied by the clinician performing the procedure. ICD-9/10 diagnostic codes were used to identify these problems.

resultsWe identified ∼850,000 cases and ∼850,000 matched controls. Overall, the rate of penile problems within the first five years of life was 1.7% in circumcised boys versus 0.5% in uncircumcised boys (p < 0.05). Multivariable regression models showed that the risk of penile problems was 2.9-fold higher among circumcised compared to uncircumcised males (95%CI [2.8-3], p < 0.001). Compared to males circumcised by pediatricians, those circumcised by surgeons had 2.1-fold higher penile problems in the year after circumcision (95% CI [2-2.3], p < 0.001). Procedure-related complications within 28 days of circumcision were infrequent (0.5%), with the most common being penile edema (0.2%).

conclusionsPenile problems are very infrequent in boys in the first five years of life. However, when they occur, they are 3x more likely to occur in circumcised boys relative to uncircumcised boys. Penile problems are more likely to occur in boys circumcised by surgeons. LEVELS OF EVIDENCE: Level II. TYPE OF STUDY: Prognosis study.

Indexed as

Circumcision, MaleDatabases, FactualPenile DiseasesPostoperative ComplicationsCase-Control StudiesChildChild, PreschoolHumansInfantInfant, NewbornMaleRetrospective StudiesUnited StatesCare providerCircumcisionComplicationHealth systems researchPenisUncircumcised

Identifiers

PMID39084960
PMCPMC11486584

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.