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A prospective evaluation of plastibell® circumcision in older children
José Murillo Bastos Netto1, José Gonçalves de Araújo, Marcos Flávio de Almeida Noronha
1Division of Urology, Department of Surgery Federal University of Juiz de Fora, Juiz de Fora, MG.
Insights
Plastibell® circumcision in children over 2 years old is a safe and quick procedure with low complication rates. The device separation time is shorter in younger children and unaffected by device diameter.
Area of Science:
- Pediatric Surgery
- Urology
Background:
- Circumcision is a common surgical procedure performed worldwide using various techniques.
- The Plastibell® device is one method used for circumcision, particularly in pediatric populations.
Purpose of the Study:
- To evaluate the outcomes of Plastibell® circumcision in children older than 2 years.
- To assess surgical duration, complication rates, and the time for device separation.
Main Methods:
- A prospective study of 119 children undergoing Plastibell® circumcision by a single surgeon.
- Procedures were performed under general anesthesia with dorsal penile nerve block.
- Measurements included penile length and glans diameter; surgical time, device separation time, and analgesic use were recorded.
Main Results:
- Mean surgical time was 3.7 minutes.
- Device separation occurred between 6-26 days (mean 16 days), with faster separation in children under 5 years (p < 0.0001).
- Late complications occurred in 26.8% of subjects, mostly minor (adhesences, edema, scar hypertrophy); meatal stenosis and device impaction were rare.
Conclusions:
- Plastibell® circumcision is a safe, quick, and simple technique with generally minor complications.
- Device separation time is shorter in younger children (<6 years) and not influenced by device diameter.
- The procedure demonstrates a favorable safety profile for pediatric circumcision.
Introduction And Objective:
Circumcision is one of the oldest surgical procedures and one of the most frequently performed worldwide. It can be done by many different techniques. This prospective series presents the results of Plastibell® circumcision in children older than 2 years of age, evaluating surgical duration, immediate and late complications, time for plastic device separation and factors associated with it.
Materials And Methods:
We prospectively analyzed 119 children submitted to Plastic Device Circumcision with Plastibell® by only one surgeon from December 2009 to June 2011. In all cases the surgery was done under general anesthesia associated with dorsal penile nerve block. Before surgery length of the penis and latero-lateral diameter of the glans were measured. Surgical duration, time of Plastibell® separation and use of analgesic medication in the post-operative period were evaluated. Patients were followed on days 15, 45, 90 and 120 after surgery.
Results:
Age at surgery varied from 2 to 12.5 (5.9 ± 2.9) years old. Mean surgical time was 3.7 ± 2.0 minutes (1.9 to 9 minutes). Time for plastic device separation ranged from 6 to 26 days (mean: 16 ± 4.2 days), being 14.8 days for children younger than 5 years of age and 17.4 days for those older than 5 years of age (p < 0.0001). The diameter of the Plastibell® does not interfered in separations time (p = 0,484). Late complications occurred in 32 (26.8%) subjects, being the great majority of low clinical significance, especially prepucial adherences, edema of the mucosa and discrete hypertrophy of the scar, all resolving with clinical treatment. One patient still using diaper had meatus stenosis and in one case the Plastibell® device stayed between the glans and the prepuce and needed to be removed manually.
Conclusions:
Circumcision using a plastic device is a safe, quick and an easy technique with low complications, that when occur are of low clinical importance and of easy resolution. The mean time for the device to fall is shorter in children under 6 years of age and it is not influenced by the diameter of the device.
