Attempted Self-Circumcision Using a Non-Medically Approved Device Purchased Online: A Case Report

Abstract

Background: Circumcision is a common urological procedure with established medical, cultural, and religious indications when performed by trained practitioners in an appropriate clinical setting. Self-circumcision using internet-purchased devices is uncommon but clinically important because it may cause uncontrolled bleeding, tissue loss, urethral injury, infection, psychological distress, and delayed presentation. This case is reported to highlight the emergency management and public health implications of online access to non-medically approved circumcision devices.

Case Presentation: A 48-year-old male presented to the emergency department 24 hours after attempting circumcision at home using a preputial stapler and cutting device purchased from an online marketplace. He reported ongoing bleeding, pain, and partially detached preputial and penile shaft skin. Clinical assessment showed a circumferential penile shaft wound with retained staples, exposed shaft tissue, and a cut approximately 7-8 mm proximal to the usual circumcision line. Blood and urine investigations were reported as normal. The patient was counselled and consented for emergency surgical repair. In theatre, staples were removed, haemostasis was secured, and primary wound repair/reconstruction was performed. A mental health assessment was completed during admission.

Conclusion: Self-circumcision using devices purchased online may result in significant penile injury requiring urgent urological assessment. Emergency clinicians should document haemodynamic status, wound extent, glans and urethral integrity, infection risk, operative management, mental health assessment, and follow-up outcomes.