Phlebectasia and Phlebothrombosis of the Penile Veins in Children after Non-Medical Circumcision

Abstract

Background: Abnormally enlarged, tortuous and dysplastic penile venous vasculature (phlebectasia) are rare in children. The prevalence of this anomaly and its possible etiologic correlation with circumcision is examined in this study. Patients and methods: This is a prospective comparative cohort study of 830 children, aged 6 months to 12 years, enrolled between June 2021 and December 2023. Among them, 420 were circumcised (group A) and 410 were intact (group B). All of them were physically examined and investigated with Doppler ultrasound for any abnormality of the penile venous vasculature. The two groups were compared for any difference in the incidence of different anomalies of the penile veins and penile deviation or chordee. Data were analyzed by Mann–Whitney U-test and a P-value less than 0.05 was considered significant. Results: Phlebectasia (21/420) and phlebothrombosis (3/420) were more frequently seen in the circumcised group, but they were rare in the intact group (2/410). These venous abnormalities were commonly seen in the dorsum of the penis (15/24). In circumcised patients, the phlebectasia was associated with penile deviation to the left side in 13 cases and a ventral penile chordee in 1 case. But, in uncircumcised children, the prominent dorsal penile vein was not associated with any chordee. An associated dilation of the deep dorsal penile vein was confirmed in 15 of the 24 cases. Conclusion: Circumcision wound and the subsequent scar may increase the incidence of abnormal penile venous vasculature which is commonly associated with penile deviation.