To explore the safety of circumcision and perioperative management in children with hemophilia A, providing evidence for developing targeted treatment protocols.

A retrospective analysis was conducted on clinical data of 9 children with hemophilia A and phimosis treated in the Department of Urology, the First People's Hospital of Kashgar Region from January 2020 to April 2023.

Among the 9 children, 6 underwent Shang-ring circumcision and 3 received conventional circumcision, all successfully completed. Empirical factor VIII supplementation was administered preoperatively: 500 IU q8h for 3-4 days in moderate hemophilia, and 250 IU q12h for 2 days in mild hemophilia. Preoperative activated partial thromboplastin time (APTT) was controlled below 45 seconds. Postoperative factor VIII supplementation discontinuation criteria included APTT <45 s combined with evaluation of local clinical signs. One child in the conventional group developed mild oozing and local swelling on postoperative day 1, which resolved after 2 days of intensified factor VIII replacement. No surgery-related complications were observed during 12-38 months of follow-up.

Circumcision is safe and feasible for children with hemophilia A and phimosis or redundant prepuce when aggressive perioperative factor VIII supplementation is implemented.