Disclaimer:
Adult circumcision remains a safe and commonly performed procedure with many proven benefits,
including reduced rates of urinary tract infection, penile cancer, and certain sexually transmitted
infections. This tool is intended to help surgeons by providing an estimated probability of composite
complications based on intraoperative vitals and patient characteristics. It should be used as an
adjunct to, not a replacement for, clinical judgment and shared decision-making with the patient
or guardian.
We compared three supervised models: logistic regression, random forest, and support vector
machines to predict short-term complications after adult male circumcision. Data from 194
patients (≥18 years) at a Milan center (2023–2024), using age, BMI, blood loss, surgical
technique (traditional vs. laser), intraop vitals, and comorbidities.
Resampling & Training
No resampling (SMOTE/ROS) was applied
Stratified 10-fold cross-validation
Standard preprocessing pipelines
Performance Metrics (SVM Best)
Metric
Point Estimate (95% CI)
AUC ROC
0.907 (0.855–0.950)
Precision / PPV
0.725 (0.623–0.826)
Average Precision
0.832 (0.735–0.913)
Sensitivity / Recall
0.862 (0.765–0.939)
Specificity
0.860 (0.797–0.915)
F1-Score
0.787 (0.706–0.857)
Brier Score
0.105 (0.077–0.134)
Model Threshold (Point Estimate)
0.238
Top Predictors (SHAP)
Intraoperative blood loss and surgical technique were the strongest predictors.
Notes & Next Steps
Strengths: rigorous CV, interpretability via SHAP.
Limitations: single-center data, no external validation.
Future: test on diverse populations and settings.
