A review of the 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 the first 1000 circumcisions with a novel disposable ring, Circumplast, in a community clinic (London and Luton) for non-therapeutic male circumcision.
Material and Methods
We reviewed the outcome of the first 1000 circumcisions performed with the 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 analysed in children under and over 3 months old. Follow-up consultations were arranged if required.
Results
- Mean age of patients: 11 ± 0.6 months (median 2, range 2 days to 11 years).
- Overall incidence of minor complications: 10% (n=101).
- No major complications reported.
- Outcomes significantly better in children under 3 months (7%, 39/554) compared to over 3 months (14%, 62/446) (p<0.05).
- Delay in ring separation significantly lower in children under 3 months (0.3% vs 2.9%) (p<0.05).
- Postoperative antibiotic use for suspected infection significantly lower in children under 3 months (3% vs 7.4%, n=17 vs 33) (P<0.05).
- Other recorded complications:
- Post-operative bleeding: 1%
- Preputial adhesions: 1%
- Buried penis: 0.6%
- Redo operations: 0.7%
- Urinary retention: 0.01%
No significant difference in these complications between children under and over 3 months (P>0.05).
Mean follow-up consultations were 16 days (range 1 to 373).
Conclusions
Non-therapeutic circumcision of baby boys with the Circumplast device can be safely performed in a community clinic.
This novel device decreases the risk of complications, especially in children under 3 months of age.
Fisher Exact test, two-tailed p value <0.05 was considered significant (GraphPad software).