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Plastibell circumcision: Comparison between neonates and infants
Osama A Bawazir1,2, Wejdan Rubayyi S Alsaiari3
1Department of Surgery, Faculty of Medicine in Umm Al-Qura University, Makkah, Saudi Arabia.
Insights
Plastibell circumcision complications are higher in infants than neonates, with retained rings being most common. This method remains a low-hemorrhage option for outpatient infant circumcisions.
Area of Science:
- Pediatric Surgery
- Urology
Background:
- The Plastibell circumcision technique is popular globally due to low bleeding risk, suitable for vulnerable populations and late circumcisions.
- Prolonged retention of the Plastibell ring has been associated with complications.
Purpose of the Study:
- To assess outcomes of Plastibell circumcision.
- To report ring-related complications.
- To compare complications between neonates and infants.
Main Methods:
- Retrospective cohort study of 989 male neonates and infants.
- Plastibell circumcision performed by a single surgeon (June 2006-February 2018).
- Postoperative complications analyzed and compared between age groups.
Main Results:
- Complications occurred in 4.4% of neonates and 17% of infants (P < 0.001).
- Retained ring (4.6%) was the most frequent complication, followed by excess skin (2%).
- Bleeding (1%), infection (0.7%), and hematoma (0.2%) were also reported.
Conclusions:
- Plastibell circumcision shows significantly higher complication rates in infants compared to neonates.
- Ring retention is the primary complication in both groups.
- Low risk of severe hemorrhage makes it a viable outpatient option for infant circumcision.
Background:
The Plastibell circumcision technique has gained popularity worldwide. It has a low bleeding risk which makes it suitable for a vulnerable population and in late circumcision. However, several problems resulting from prolonged retention of the Plastibell ring were reported.
Objectives:
The objectives of this study were to assess the outcomes of circumcision performed using Plastibell devices, report ring-related complications, and compare the complications of the technique between neonates and infants.
Methods:
This was a retrospective cohort study that was conducted in a total of 989 male neonates and infants who had Plastibell circumcision performed by a single surgeon between June 2006 and February 2018. Postoperative complications were reported and compared between the two age groups. The indications of the Plastibell technique were religious in 988 patients and urinary tract infection in 1 patient.
Results:
During the study period, Plastibell circumcision was performed in 633 neonates and 356 infants. The average ages of neonates and infants were 14 ± 2 days and 3 ± 0.5 months, respectively. Complications developed in 89 cases, 4.4% in neonates and 17% in infants (P < 0.001). The retained ring was the most common complication in 46 cases (4.6%), followed by excess skin in 21 cases (2%). Bleeding occurred in 10 cases (1%), infection in 7 cases (0.7%), and hematoma in 2 cases (0.2%).
Conclusion:
Complications of Plastibell circumcision are significantly higher in infants than in neonates, and ring retention is the most common complication in both the groups. However, the risk of severe hemorrhage is low making it a good option for infants in the outpatient setting.
