Characterization of Newborn Circumcision Revision and Complication Rates Among Privately Insured Boys in the United States Between 2010 and 2022 - 28/02/25

Doi : 10.1016/j.urology.2025.02.017

David D. Kim ^a, Max J. Hyman ^b, Parth K. Modi ^a, Emilie K. Johnson ^c,^d,^⁎
^a Section of Urology, Department of Surgery, The University of Chicago Medical Center, Chicago, IL
^b The Center for Health and the Social Sciences, The University of Chicago, Chicago, IL
^c Division of Urology, Ann and Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL
^d Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL

^⁎Address correspondence to: Emilie K. Johnson, M.D., M.P.H., Ann and Robert Lurie Children’s Hospital of Chicago, Chicago, IL 60611-2605.Ann and Robert Lurie Children’s Hospital of ChicagoChicagoIL60611-2605

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Résumé

Objective

To investigate national trends in newborn circumcision complication and secondary procedure rates and whether clinician specialty affects these rates.

Methods

The Merative MarketScan Database was queried for claims from 2010 to 2022. CPT 54150 identified newborn circumcisions; CPT 54162, 54163, 54164, 54300, and 54450 identified secondary procedures; ICD-9 and ICD-10 codes identified complications. Multivariable logistic regression was performed to analyze the association between clinician specialty and circumcision revision or secondary procedure.

Results

A thirty-day complication was coded for 0.96% of newborns. Two- and five-year secondary procedure rates decreased from 2.90% and 3.62% in 2010 to 2.45% in 2020 and 2.89% in 2017, respectively. Compared to newborn circumcisions performed by obstetrician/gynecologists, the odds of secondary procedure within 2 years were lower for those performed by pediatricians (OR 0.73, 95% CI 0.68-0.78, P <.001), pediatric surgeons (0.57 [0.42–0.76], P <.001), advanced practice clinicians (APC) (0.80 [0.65-0.98], P = .03), and other clinicians (0.67 [0.63-0.71], P <.001). Compared to newborn circumcisions performed by obstetricians/gynecologists, the odds of revision within 2 years were lower for those performed by pediatricians (0.46 [0.42-0.51], P <.001), urologists (0.29 [0.19-0.44], P <.001), pediatric urologists (0.38 [0.22-0.66], P = .001), pediatric surgeons (0.60 [0.36-0.98], P = .04), and other clinicians (0.59 [0.52-0.66], P <.001).

Conclusion

Revision rates did not increase over time, and secondary procedure rates slowly declined. Compared to newborn circumcisions performed by obstetrician/gynecologists, the odds of a secondary procedure were either not different or lower for those performed by all other specialties, including APCs, suggesting that newborn circumcision workforce planning should involve training of and collaboration with APCs.

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