Circumplast vs Plastibell in Non-Therapeutic Male Circumcision

By: Dr. Khan

Published: November 5, 2016

Dr Khan presented this study at the annual congress of the European Society of Paediatric Urologists in Harrogate, England, UK.

Purpose

This cohort study evaluated 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 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 was significantly lower in CC (6.3% n=13/208) versus PC (13% n=154/1179) (p<0.05).
  • Delayed ring separation/migration was 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.
  • 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 was 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

Dr. A.R Khan

Paediatric Surgeon/Urologist

Bio

BSC, MBBS, FRCS, FEBPS, FRCS (PAEDS)
Dr. Khan is a highly experienced and respected paediatric surgeon and urologist with a distinguished career that spans over three decades. He has performed more than 7,000 circumcisions in the UK and is recognised for his expertise in treating foreskin problems, buried penis, and hypospadias. Dr. Khan is also pioneering new techniques in circumcisions for adults, children, and infants, ensuring the highest standards of care for his patients.
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