A Complication Of Circumcision

To the Editor:—  A serious complication of circ[ill]cision unmentioned in the refere[ill]s given by Lackey et al (206:2318, 1968) is that of surgically bivalving either the dorsal or ventral half of the glans penis. This is caused by inadvertent placement of one limb of the scissors into the urethra rather than between the foreskin and the glans prior to performing either the dorsal or ventral slit in the prepuce. These fortunately rare cases are those with pinpoint openings in the phimotic foreskin with the glandular meatus just beneath. If the adhesions of the inner surface of the foreskin and glans penis are not reduced, the line of least resistance to placement of instrument within the foreskin is the urethra itself. Once the incision is made, the glans penis is bivalved and the urethra laid open. In effect, a first degree hypospadius or epispadius has been produced.While avoidance of