Ergebnisse nach Zirkumzision bei Kindern – welche Faktoren beeinflussen die Elternzufriedenheit?

Outcomes after circumcision in children - factors influencing parental satisfaction

by Maja Kleine-Büning
Doctoral thesis
Date of Examination:2025-11-03
Date of issue:2025-10-28
Advisor:PD Dr. Marianne Leitsmann
Referee:PD Dr. Marianne Leitsmann
Referee:PD Dr. Johannes Uhlig
Persistent Address: http://dx.doi.org/10.53846/goediss-11591

 

 

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Abstract

English

In Germany, slightly more than 100,000 circumcisions are performed annually, with 10.9% of boys aged 0–17 years being circumcised. The decision to circumcise a child often presents a challenge for parents. Medically indicated circumcision is performed according to clinical guidelines for pathological phimosis after unsuccessful conservative treatment (primarily with corticosteroid-based ointments). However, depending on the underlying condition – such as suspected lichen sclerosus or severe scarring - primary circumcision may also be indicated. Reported complication rates vary widely in the literature (0.19–16%), largely depending on whether the procedure was performed by medical professionals or non-professionals, and by differing definitions and classifications of complications. Severe complications are generally rare. This retrospective questionnaire-based study investigated significant factors influencing parental satisfaction after their child’s circumcision. A total of 379 patients circumcised at the University Medical Center Göttingen between 2005 and 2012 were invited; 66 parents (17.4%) responded. Data from questionnaires and medical records were analyzed (significance level p < 0.05). Overall, 68.2% of parents were satisfied, while 31.8% were dissatisfied. Factors significantly associated with lower parental satisfaction included preoperative agitation and anxiety in children and parents (p = 0.040), postoperative pain (p = 0.003), and unsatisfactory cosmetic results (p ≤ 0.001). These findings are consistent with previous studies. The preoperative phase is often associated with considerable anxiety, particularly in younger children. Perioperative anxiety is also linked to increased postoperative pain and higher analgesic requirements. Cosmetic outcome remains the strongest predictor of parental satisfaction and the most common reason for planned revision surgeries. The results highlight the importance of comprehensive preoperative information, psychological preparation for both children and parents, effective perioperative pain management, and attention to cosmetic outcomes to improve parental satisfaction after pediatric circumcision.
Keywords: circumcision; complication after circumcision; parental satisfaction after child’s circumcision
Schlagwörter: Zirkumzision Kinder; Elternzufriedenheit nach Zirkumzision der Kinder; Komplikationen nach Zirkumzision
 
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