COMPARISON OF COMPLICATIONS OF CIRCUMCISION BY 'PLASTIBELL DEVICE TECHNIQUE' IN MALE NEONATES AND INFANTS

To determine the effectiveness of the circumcision by Plastibell technique comparing the complications among neonate and infant age groups.

OUTCOME OF USE OF PLASTIBELL DEVICE FOR CIRCUMCISION IN PAEDIATRIC PATIENTS

Introduction – Circumcision is one of the oldestsurgical procedure practiced to remove shaft skinand inner foreskin to uncover the glans.Among various techniques for the circumcision, wehave described Plastibell method which has becomepopular and more preferable for its advantages suchas minimal tissue trauma and better cosmesis.Aim - This article aims to analyse the safety, efficacyand outcome of plastibell circumcision in paediatricpatients.Material & Methods – This study includes 30inpatient cases who satisfied the inclusion criteriaand underwent circumcision using plastibell device atsheth L.G. hospital, AMC MET Medical college,Ahmedabad. Data on operative time, intra op andpost op complications, post operative hospital stay,cosmetic outcome and parent satisfaction wasobtained and analysed.Results – Total of 30 patients were circumcised withplastibell device with average operative time of 9±3mins. Most common post-operative complication waspain which was observed in 8 patients (26.67%).Post-op bleeding was seen in 1 patient (3.33%) dueto detachment of ring. 28 out of 30 parents weresatisfied with the cosmetic outcome.Conclusion – Based on our study, plastibellcircumcision is effective technique for circumcisionoffering lesser operating time, post-operative pain,

Retrospective study of the minor complicationsin the plastibell© circumcision / Estudo retrospectivo das complicações menores na circuncisão com Plastibell

Introduction. Published complications such as urinary retention, necrotizing faciites, uretral fistula or local infection regarding circumcision with Plastibell device© are too severe for such a simple procedure mostly if followed some important steps in its procedure. Objective. To present a retrospective analysis of minor complications of circumcision with Plastibell device© that were quite different from those presented in the literature. Methods. In a four years period, 492 boys between 1-10 years old were submitted to circumcision with Plastibell ©. Anesthesia was started with midazolam per oral followed by administration of sevoflurane through inhalation. A dorsal penile nerve block was performed in all 492 boys with bupivacaine 0,5%. Plastibell© was used in 4 different sizes: n.º 1.5 in 205 (41.7%) boys, n.º 1.3 in 118 (24%), n.º 1.7 in 103 (20.9%), and n.º 1.4 in 66 (13.4%). Results. Early complications were local hematoma in 40 (8.1%) boys, meatitis in 33 (6.7%), and slight bleeding in 18 (3.7%). Late complications occurred in 34 boys (6.9%) with preputial retraction, 18 (3.7%) with balanoposthitis and 5 boys (1%) with stenosis of the urethral meatus. None of them had to be re-operated because of these complications. There was only one case of paraphimosis that was treated with a simple hand reduction maneuver of the glans. Conclusion. There were no severe complications in this retrospective analysis as those described in the literature. Circumcision with Plastibell© is a fast and safe procedure, with low rate of light complications if observed important steps in the surgery procedure.

Introdução. Complicações publicadas tais como retenção urinária, facites necrosantes, fistula uretral ou infecção local relacionadas a circuncisão com Plastibell© são demasiado intensas para um simples procedimento principalmente se seguindo a importantes passos no seu procedimento. Objetivo. Apresentar análise retrospectiva de complicações menores de circuncisão com Plastibell© as quais foram diferentes daquelas apresentadas na literatura Métodos. Em um período de quatro anos, 492 meninos de 1 a 10 anos foram submetidos à circuncisão com Plastibell© A anestesia foi iniciada com midazolam por via oral seguida pela administração de sevoflurano por meio de inalação. O bloqueio do nervo dorsal do pênis foi realizado em todos os pacientes com bupivacaina 0,5%. foi usado Plastibell© em quatro diferentes tamanhos: n.º 1,5 em 205 (41,7%) meninos, n.º 1,3 em 118 (24,0%), n.º 1,7 em 103 (20,9%) e n.º 1,4 em 66 (13,4%). Resultados. As complicações precoces foram hematoma local em 40 (8,1%) meninos, meatites em 33 (6,7%) e pequeno sangramento em 18 (3,7%). Complicações tardias ocorreram em 34 meninos (6,9%) com retraçãoprepucial, 18 (3,7%) com balanopostites e cinco meninos (1,0%) com estenose de meato uretral. Nenhum deles necessitou ser reoperado devido a essas complicações. Ocorreu um caso de parafimose que foi tratada com uma simples manobra manual de redução da glande. Conclusão. Não ocorreu nenhuma das complicações graves nesta análise retrospectiva como descrito na literatura. A circuncisão com Plastibell© é um rápido e seguro procedimento, com menor taxa de leves complicações se observados importantes passos nos procedimentos cirúrgicos.