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Prospective randomized trial comparing dissection with Plastibell® circumcision
José Murillo Bastos Netto1, José Gonçalves de Araújo, Marcos Flávio de Almeida Noronha
1Federal University of Juiz de Fora - Department of Morphology, Brazil. jmbnetto@uropedjf.com.br
Journal of Pediatric Urology
|February 16, 2010
Summary
Plastibell circumcision offers faster surgery and fewer late complications like adhesions compared to dissection circumcision. However, it requires more pain relief after the third day post-operation.
Area of Science:
- Pediatric Surgery
- Urology
Background:
- Phimosis is a common condition in pediatric patients requiring surgical intervention.
- Circumcision is a widely performed procedure for phimosis treatment.
- Evaluating different circumcision techniques is crucial for optimizing patient outcomes.
Purpose of the Study:
- To compare the efficacy and safety of dissection circumcision (DC) and Plastibell(®) circumcision (PD) for treating phimosis in children.
- To assess surgical duration, complication rates, and postoperative pain management between the two techniques.
Main Methods:
- A randomized controlled trial involving 125 children undergoing circumcision for phimosis.
- Children were divided into two groups: dissection circumcision (DC) and Plastibell(®) circumcision (PD).
- Procedures were performed under general anesthesia with dorsal penile block, followed by follow-up at 15, 45, and 90 days.
Main Results:
- Plastibell(®) circumcision had a significantly shorter surgical time (3.29 min) compared to dissection circumcision (14.64 min).
- Late complications, particularly adhesions, were significantly higher in the dissection group (P < 0.01).
- Postoperative pain medication use was similar for the first two days, but higher in the Plastibell(®) group from day three onwards (P < 0.05).
Conclusions:
- Plastibell(®) circumcision is associated with reduced surgical duration and fewer late complications, such as adhesions.
- Dissection circumcision resulted in a higher incidence of late complications.
- While Plastibell(®) offers advantages in surgical time and complication rates, it necessitates increased analgesic use in the later postoperative period.
