Plastibell circumcision in neonates: A review of procedure and analysis of complications

Abstract

Introduction: Male circumcision involves surgical removal of prepuce that covers the glans penis. Plastibell, Gomco clamp, Mogens clamp are most commonly used devices in neonatal circumcision. Aims: The aim of this restrospective study was to evaluate circumcision done by Plastibell device in neonates. We reviewed the outcomes including the appearance, ease and safety of use and the complications of this procedure. The nuances of this simple procedure are described and the need for skilled surgeons to perform it to make it free of the serious complications has been emphasized. Methodology: This retrospective study included 108 physiologically stable neonates with low to normal birth weight who underwent Plastibell circumcision by a single surgeon at hospitals across National Capital Region, India. Neonates with congenital abnormalities like hypospadias, sick, very low birth weight were not taken for operation. Results: Complications occurred in above mentioned cases were- redundant skin [02/108], ring slippage with bleeding [01/108], early ring fell off [02/108], infection [0/108], fringe of skin left [01/108]. All [06/108] complications could be managed satisfactorily. Discussion: Plastibell circumcision is a safe procedure and can be done under local anaesthesia. It has got superior cosmetic results and parental acceptance is very high. It requires an experienced surgeon to do the procedure with best results. To avoid rare life threatening or serious complications this is not the preferred method in older children as there is limitation of available sizes, higher chances of slippage and requirement of sedation even if the size is suitable.