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Avoidance of general anesthesia for circumcision in infants under 6 months of age using a modified Plastibell
Thanh Tam Nguyen1, Elizabeth Kraft2, Ziyad Nasrawi2
1Department of Surgery, New York Presbyterian Brooklyn Methodist Hospital, 506 6th street, Brooklyn, NY, 11215, USA. tammytnguyen2013@gmail.com.
Insights
A modified Plastibell circumcision technique is safe for infants aged 1-6 months. This method, performed with local anesthesia, avoids general anesthesia risks for delayed infant circumcisions.
Area of Science:
- Pediatric Surgery
- Urology
Background:
- No established standard for analgesia or technique in infant circumcision after one month.
- Delayed circumcision may necessitate general anesthesia, posing risks.
Purpose of the Study:
- To present a modified Plastibell circumcision technique for infants aged 1-6 months.
- To evaluate the safety and outcomes of this technique under local anesthesia.
Main Methods:
- Retrospective case series of 508 male infants (1-6 months old).
- Circumcision performed using a modified Plastibell technique under local anesthesia.
- Postoperative complications monitored: hemorrhage, infection, revision, urethral meatotomy.
Main Results:
- Zero cases of re-operation for hemorrhage, wound infection, or circumcision revision.
- One instance of urethral meatal stenosis requiring meatotomy.
Conclusions:
- Modified Plastibell circumcision under local anesthesia is safe and reproducible for infants 1-6 months.
- Offers an alternative to general anesthesia for delayed circumcisions.
Purpose:
There is currently no gold standard for the type of analgesia or preferred circumcision technique in infants requiring circumcision after 1 month of age. Our study presents a modified Plastibell circumcision technique, which offers excellent surgical outcomes, and can be performed under local anesthesia until 6 months of age, thereby avoiding the risks of general anesthesia in delayed circumcision.
Methods:
This is a retrospective case series of 508 consecutive male infants between 1 and 6 months of age, from one institution, who all underwent circumcision under local anesthesia, performed by the same pediatric surgeon, from 2013 to 2018. The study parameters included postoperative complications such as re-operation for control of hemorrhage, wound infection, circumcision revision, and urethral meatotomy.
Results:
There were no re-operations for control of hemorrhage, no wound infections, and no circumcision revisions. One patient developed urethral meatal stenosis requiring urethral meatotomy.
Conclusion:
Our modified Plastibell circumcision technique under local anesthesia is a safe and reproducible alternative for infants between 1 and 6 months of age, whose parents desire circumcision and wish to avoid general anesthesia.
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