A three-year-old boy in India had his penis completely amputated during a ritual circumcision performed by a local barber, and surgeons managed to save it using a relatively simple grafting technique instead of full microsurgery, according to a new medical report.
The case, published in the Indian Journal of Plastic Surgery, details how doctors at King George Medical University in Lucknow reattached the organ eight hours after the injury, despite being unable to reconnect the tiny arteries that normally supply it with blood. This case was categorized as Khitan, which is a tradition in Islam, also known as circumcision, and is a widely practiced religious and cultural ritual for Muslim males, based on the teachings of the Prophet Muhammad.
Three-year-old injured during barber-led ritual
According to the report, the boy was brought to the plastic surgery unit after a total subcoronal penile amputation, meaning the penis was cut off just below the head, during a ritual circumcision performed by a layperson described as a local barber.
The amputated part was preserved and transported with the child to the hospital, where surgeons first attempted a full replantation, which in ideal cases involves microsurgical reconnection of arteries and veins under a powerful operating microscope.
But the penis's arteries were too small for repair, so the team had to find another option.
Faced with this limitation, the team opted to sew the penis back on as a composite graft, reattaching the organ without reconnecting all the tiny arteries.
They were able to connect one dorsal vein and relied on the tissues around it to slowly bring blood flow back to the reattached penis.
Despite the long delay without blood supply and the limited vascular repair, the graft survived and the penis remained viable, leading the authors to describe the outcome as a successful “take” of the composite graft.
Implications for ritual circumcision safety
The authors note that ritual circumcision, known as khitan or khatna, is widely practiced among boys in Jewish and Muslim communities, and that when it is carried out by untrained barbers in non-medical conditions, it can lead to complications ranging from infection and scarring to catastrophic injuries such as partial or total penile amputation.
Circumcision performed by trained medical staff or certified mohalim has low rates of serious complications and is generally considered safe when basic hygiene and surgical standards are followed.
In the past, however, rare but serious complications in Israel have led to infants needing complicated reconstructive surgery after botched circumcisions. This has led to calls for clearer oversight and training requirements for practitioners.
Lessons for parents and communities
For parents, the central message from the case is that circumcision is a surgical procedure and should be treated like one, with proper equipment, sterile technique, and trained professionals in attendance.
Public health experts stress that relying on certified mohalim or physicians, and avoiding improvised, non-medical settings, dramatically reduces the risk of serious harm to infants and young children.