Related Experiment Video
Updated: Mar 20, 2026
Microscopic Replantation of Penile Glans Amputation Due to Circumcision
Published on: June 3, 2022
Plastibell circumcision of 2,276 male infants: a multi-centre study
Bioku Muftau Jimoh1, Ikuerowo Stephen Odunayo2, Igwilo Chinwe3
1Department of Surgery, Federal Staff Medical Centre, Abuja.
Insights
The Plastibell technique for infant circumcision is safe and effective, with a low complication rate of 1.1% in a multi-center study. Religious and cultural reasons were the primary drivers for the procedure in this environment.
Area of Science:
- Pediatric Surgery
- Urology
Background:
- The World Health Organization recognizes the Plastibell technique as a proven pediatric circumcision method.
- Limited multi-centered reports exist on its application in certain regions.
- This study aimed to evaluate infant circumcisions using the Plastibell device across two medical institutions.
Purpose of the Study:
- To assess the safety and efficacy of the Plastibell technique for infant circumcision.
- To analyze the indications, complications, and outcomes of Plastibell circumcisions in a multi-center setting.
Main Methods:
- A cross-sectional study of 2,276 infants undergoing Classical Plastibell Circumcision (PC) between February 2011 and June 2015.
- Procedures performed by surgical registrars and medical officers after topical anesthesia.
- Data analyzed using SPSS 20.0.
Main Results:
- The mean age at circumcision was 17 days, with most infants circumcised in the second week of life.
- Religious (53%) and cultural (47%) reasons were the primary indications.
- An overall complication rate of 1.1% was observed, with postoperative bleeding being the most common (48% of complications).
- No urethrocutaneous fistula cases were reported; 17 cases (0.7%) of distal hypospadias were identified and circumcision was postponed.
Conclusions:
- Infant circumcision in this region is predominantly for religious reasons.
- The Plastibell technique demonstrates a favorable safety profile with manageable early complications.
- Proper ligature placement, appropriate device size selection, and comprehensive parental education are crucial for preventing complications.
Introduction:
The World Health Organization's manual on male circumcision listed Plastibell technique as a well-proven paediatric method with respect to the results and complications. Although, literatures abound on its wide acceptability, there are few multi-centered reports from this environment. The objective was to evaluate the cases of infant circumcision by Plastibell device from two medical institutions.
Methods:
All consecutive infants who had Classical Plastibell Circumcision (PC) at the Federal Staff Medical Centre, Abuja and the Lagos State University Teaching Hospital, Ikeja between February 2011 and June 2015 were included in this cross-sectional study. The procedures were performed by surgical registrars and medical officers after ninety minutes of topical anesthesia to the penis. Data harvested from the standard proforma were analysed using Statistical Package for Social Science 20.0 for window.
Results:
A total of 2,276 infants had classical PC within the study period. Their ages at circumcision ranged from 4 days to 3 months with a mean age of 17 days. Majority of the boys were circumcised at second week of life (n=1,394,61.2%). All the cases were performed for religious (53%) and cultural (47%)reasons. The most common Plastibell size deployed was 1.3 cm (n=1,040, 45.7%) while 1.6 cm was the least commonly used ring (n=10, 0.4%). The mean time for device to fall-off was 6 days (range 4-12 days). There was no correlation between the age at circumcision and Plastibell size. We recorded an overall complication rate of 1.1% with postoperative bleeding leading the pack (n=12, 48%). No case of urethrocutaneous fistula was seen. We detected 17 cases (0.7%) of distal hypospadias in whom circumcisions were postponed till the time of hypospadias repairs.
Conclusion:
The main indication for infant circumcision in our environment was religious. The PC has good safety profile with few easily correctable early complications. Detailed attention to placement of ligature, selection of appropriate Plastibell size and adequate parental education are key to preventing post-procedure mishaps.
