Non-therapeutic male circumcision in children with a novel disposable ring - Circumplast improves the outcome as compared to the standard Plastibell device at a community clinic

Dr Khan presented this study the annual congress of European Society Pediatric Urologists at Herrogate, England, UK

PURPOSE

This cohort study will evaluate the early postoperative complications in Circumplast® and Plastibell®techniques, in a community clinic, for non-therapeutic male circumcision at Thornhill clinic and Leyton clinic. 

MATERIAL AND METHODS

We reviewed the outcome of non-therapeutic male circumcision in children (n=1387) over a 1 year period (May 2014 to April 2015) in a community clinic, performed under local anaesthesia, by trained doctors with the backup of a trained paediatric surgeon. The technique was selected by doctors’ preference. Data was collected prospectively and early postoperative complications were compared between Circumplast® and Plastibell® circumcisions. Follow-up consultations were arranged if required.

RESULTS

The mean age was 18 ± 1.9 months (median 5.1) in Circumplast® circumcision (CC) and 9.4 ± 0.6 months (median 1.5) in Plastibell® circumcision (PC). Incidence of complications is significantly lower in CC (6.3% n=13/208) versus PC (13% n=154/1179) (p<0.05). Delayed ring separation/migration is significantly lower in CC (3.2% n=7/208) versus PC (8.7% n=102/1179) (p<0.05). Post-operative bleeding (0.5% vs 0.6% n= 1 vs 7), preputial adhesions (1.4% vs 2.4% n= 3 vs 28), and miscellaneous complications (0.5% vs 1% n= 1 vs 13) were lower but not statistically significant (p>0.5) in CC versus PC respectively. Postoperative use of antibiotics was higher in CC versus PC (6.7% vs 3.8% n=14 vs 45) but not statistically significant (P>0.05). In children under 6 months, the overall outcome in both groups is significantly better in comparison to 6 - 110 months old (p<0.05). Mean follow-up consultations were 19 days (range 1 to 373) in CC and 20 days (range 1 to 305) in PC.

CONCLUSIONS

Non-therapeutic male circumcision by the Circumplast® device has a significantly lower risk of early postoperative complications in a community clinic, especially migration/impaction of the ring when compared to the standard Plastibell® device.

source: ESPU 2016 website.