After this the baby was found to be fussy and constantly crying and was no longer tolerating his feeds. He then started to become lethargic and show progressive abdominal distension.

Careful examination of the site of circumcision revealed that the glans penis was ischemic with signs of inflammation at the shaft

A clear line of demarcation was visible at the time of surgery between the gangrenous and healthy penile tissue as almost a week had passed since the initial injury. This prompted us to perform debridement of the dead tissue to avoid sending the patient for a second general anesthetic.

Our hypothesis is that the distal end of the glans had become caught in the device causing a crush injury to it and the most distal part of the urethra and this wasn't managed correctly unfortunately. This caused an acute urinary retention that was missed on initial examination and ultimately led to pressure build up and bladder rupture.

Long-term monitoring of patients where suturing in done near the trigone is vital as such patients are at a higher risk of long-term bladder dysfunction.[11] We were unable to do so in this patient unfortunately as he was lost to follow-up.

This is why they feel that routine nontherapeutic practice of circumcision should be restricted to those subgroups of patients. To add to this point, it was found that the risk rate for the development of meatal stenosis and other urethral stricture diseases was higher in religious and cultural ethnicities that practiced nontherapeutic circumcision.

It is our message that although circumcision is performed routinely in many cultures, it can still lead to catastrophic and life-threatening problems adding a considerable cost to the already taxed health services especially in low- and middle-income countries.