Bringing Jewish ritual circumcision (Brit Milah) into the operating room: An analysis of surgical outcomes and satisfaction across families and Society of Pediatric Urology members

Alexander Koven, Fardod O'Kelly, Ali El-Ghazzaoui, Jacob C Langer, David Levin, Aubie Diamond, Yisroel Goldstein, Ezriel Reichman, Martin A Koyle
Urology 2021 January 19

OBJECTIVES: To assess caregiver satisfaction, procedural outcomes and practitioner opinion regarding a novel program designed for patients to undergo a deferred Jewish ritual circumcision (Brit Milah) in the operating room (OR), combined with other indicated surgical procedures.

METHODS: All patients undergoing Brit Milah in the OR at our institution between 2013-2019 were included. Surveys were administered to assess caregiver satisfaction and Society for Pediatric Urology (SPU) member practice patterns. A retrospective case-control series was completed to compare complication rates and operative times for procedures with and without Brit Milah.

RESULTS: 44 intra-operative Brit Milah patients were identified. The mean procedure time for a distal hypospadias repair with Brit Milah was 66.0 min, compared to 62.4 min without (p=0.57). No complications were attributable to the addition of Brit Milah. The caregiver survey had a 100% response rate. The modal response for satisfaction with the peri-operative experience was 5/5 (i.e. highly satisfied), with 100% of respondents very likely to recommend the program. 132 active SPU members responded to the survey (34.1% response rate) with 44% regularly allowing Brit Milah in the OR at their institution. 90.5% received positive caregiver feedback and 64% believe it is important to offer.

CONCLUSIONS: This novel program incorporating Brit Milah into the OR yields high caregiver satisfaction, no additional OR time or post-operative complications, and provides an opportunity to combine family-centered care with cultural competence.

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