A review of first 1000 circumcisions in boys with a novel disposable ring in a community clinic.

Thornhill Circumcision Clinic, Luton and Leyton Clinic, London

PURPOSE

We evaluated postoperative complications in first 1000 circumcisions with a novel disposable ring, Circumplast, in a community clinic (London and Luton Clinic) for non-therapeutic male circumcision.

MATERIAL AND METHODS

We reviewed the outcome of first 1000 circumcisions performed with Circumplast device in children from May 2014 to October 2016 in a community clinic. Data were collected prospectively and all circumcisions were performed under local anaesthesia, by trained doctors with the backup of a trained paediatric surgeon. Early and late complications were assessed. Complications were further looked for under and over 3 months old. Follow-up consultation/visit were arranged if required.

RESULTS

The mean age of the patients was 11 ± 0.6 months (median 2, range 2 days to 11 years). The overall incidence of minor complications was 10% (n=101).

There is no major complication.

The outcome was significantly better in children under 3 months (7%, 39/554) over than 3 months (14%, 62/446) (p<0.05). Delay in ring separation is significantly lower in children under 3 months (0.3% to 2.9%) (p<0.05). Postoperative use of antibiotics for suspected infection was also significantly lower in children under 3 months (3% vs 7.4% n=17 vs 33) (P<0.05).

Post-operative bleeding (1%), preputial adhesions (1%), buried penis (0.6%), redo operations (0.7%), and urinary retention (0.01%) were recorded, but there was no significant difference in children under 3 months (P>0.05). Mean follow-up consultations were 16 days (range 1 to 373).

CONCLUSIONS

Non-therapeutic baby boys circumcision by the Circumplast device can be safely performed in a community clinic. This novel device decreases the risks of complication especially in children under 3 months of age.

Fisher Exact test, two tailed p value, <0.05 is significant, was done by Graphpad software