ACUTE OBSTRUCTIVE UROPATHY - A RARE COMPLICATION OF CIRCUMCISION

We report a rare complication of ritual circumcision in an 8-week-old boy. He presented 1 week after the procedure with reduced urine output , a grossly distended bladder and marked bilateral hydroureteronephros is on ultrasonography. The acute partial urinary obstruction was due t o the dressing which was applied after surgical removal of the foreski n and to oedema of the glans. He had abnormal renal function (creatini ne 85 mu mol/l, urea 8.5 mmol/l) and a hyperkalaemic metabolic acidosi s with hyponatraemia (Na 127 mmol/l, K 6.9 mmol/l, HCO3 16 mmol/l), wh ich were attributed to obstructive uropathy. Because of prolonged seco ndary bladder dysfunction he required urinary catheterisation for 1 we ek. There was significant post obstructive diuresis and parenteral flu id therapy was given for 7 days. Whilst urinary retention is a well re cognised complication of circumcision, this is the first report of sig nificant obstructive uropathy and renal impairment due to surgical exc ision of the foreskin.