Bone cutter versus plastibell device in neonatal circumcision: A randomized trial (original) (raw)
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Pakistan Journal of Medical Sciences, 1969
Objective: To compare the rate of complications of Plastibell and bone cutter circumcision technique and recognition of top worries and satisfaction rate in the mind of parents before and after the procedure of Plastibell device (PD) circumcision in infants less than 6 months of age. Methods: It was a descriptive prospective study conducted at department of surgery Sheikh Zayed Hospital, Rahim Yar Khan. Two hundred parents of infants of less than six months of age were recruited for this study. Infants were divided into two equal groups. Group I included Plastibell circumcision technique and Group II included Bone Cutter Circumcision technique. Data was analyzed using SPSS Version 17. Independent sample t-test and chi-square test was used to compare quantitative and qualitative variables respectively. P-value <0.05 was taken as significant difference. Results: Total number of two hundred infants were included in this study. Most common worries of parents about Plastibell Device circumcision were; fear of fever (42.0%). Fear of pain and bleeding (66.0%). Plastibell Device method was associated with less operation time and bleeding as compared to bone cutter method (P-value <0.0001 and <0.0001 respectively). Incidence of complications other than bleeding and infection was 3.0% in bone cutter method and 1.0% in Plastibell device method. Pain score was significantly less in plastibell device group (p-value <0.0001). Post-operatively, 98% parents showed complete procedural satisfaction in Plastibell group versus 87% parents in bone cutter one month after surgery (P-value 0.003). About 4% parents in bone cutter method group showed cosmetic displeasure versus only 1% parents in plastibell device group. Conclusion: The study concluded that Plastibell Device circumcision is a safer technique for circumcision and is associated with highest level of parent's satisfaction.
Safety of the plastibell circumcision in neonates, infants, and older children
International Journal of Health Sciences, 2018
Objectives: The objectives of this study were to determine the safety of the Plastibell device (PD) circumcision in neonates, infants, and older children. Patients and Methods: A prospective, descriptive study was conducted in private clinics of district Poonch and district Sudhanuti Azad Kashmir, Pakistan, during the period from November 2014 to August 2017. Research was conducted in light of guidelines set by Helsinki declaration. Healthy male babies free of any clinical signs of illness and congenital anomaly were included in the study. The babies having weight <3 kg at the time of surgery were excluded from the study. The parents/guardian were explained about the procedure and informed consent was taken. The complications that developed postoperatively were recorded. The record of all cases was analyzed retrospectively for safety outcome and complications developed in neonates, infants, and older children. Results: A total of 1000 cases including 655 (65.5%) neonates, 241 (24...
JPMA. The Journal of the Pakistan Medical Association, 2010
To determine the effectiveness of the circumcision by Plastibell technique with comparison of complications among neonate and infant age groups. A retrospective, descriptive study was conducted in all the plastibell circumcisions performed by the first author, during the period October 2006 to December 2008 at a private hospital Karachi. The record of all the cases fulfilling the inclusion criteria were obtained and analyzed for determining the outcome and complications if any in neonates and infants and to compare it with in these two groups. Overall 245 cases of neonates and infants were selected. Mean age of neonates and infants was 14 +/- 2 days and 3 +/- 0.5 months respectively. The plastibell circumcision was done in all the cases i.e. 90 neonates and 155 infants. Out of these, the successful rate of plastibell circumcision without any complication was recorded as 196 cases (80.00%) whereas, 49 cases (20.00%) developed complications. In neonates it was recorded as 04.44% cases...
Advances in Urology, 2008
Conventional dissection surgery (CDS) or using the Plastibell device (PD) is the method most frequently employed for circumcision. The aim of this study was to evaluate two methods in terms of the incidence of complications in infants of ages up to 12 months. In a prospective study, 586 infants equal to or less than 12 months were studied from 2002 to 2008, and complications between the two groups were assessed. The overall rates of complications in CDS and PD groups were 1.95% and 7.08%, respectively. In each group, the rate of complications was not different among children who had a normal weight, compared to those of a lower or upper (10%) weight. There was a significant positive correlation between the age and weight of subjects within the time of ring separation (). The results of this study suggest the PD method for neonates and low-weight infants with thin prepuce and the CDS for other infants.
A controlled trial of Gomco versus Plastibell for neonatal circumcisions in Saudi Arabia
International Journal of Pediatrics and Adolescent Medicine, 2019
Background: Gomco or Plastibell devices are the most widely used method for circumcision. The present work was aimed to assess the incidence of complications in infants of ages up to six months in two used methods. Methods: It was a prospective randomized study conducted at a pediatric surgery clinic in 3 hospitals in Jeddah, Saudi Arabia. Eight hundred and five children, their ages were less than 6 months were enrolled for the present work. Children were randomized into two groups: Groups P and G using Plastibell and Gomco Circumcision methods, respectively. Statistical analysis of data was performed by using SPSS Version 17. Chi-square test and independent sample t-test was applied to compare both qualitative and quantitative variables, respectively. P-value was considered as significant difference at <0.05. Results: Seven hundred eighty three children were were enrolled in this investigation. Plastibell method was concomitant with low volume of bleeding in comparison with Gomco method (P < 0.001). Incidence of complications including infection, penile edema, proximal migration and redundant skin was higher in Plastibell device method (P<0.05). Conclusion: Gomco circumcision is the safer method and is accompanied with lowest rate of complication.
Journal of Evidence Based Medicine and Healthcare
BACKGROUND Conventional Dissection Surgery (CDS) and Plastibell Device (PD) are the commonly used techniques for male circumcision. We wanted to evaluate and compare the postoperative problems and aesthetic results, and the patient’s / parent’s acceptance, of the two techniques of circumcision in boys. METHODS This was a prospective study in which children in the age group 0 - 12 years attending the surgery outpatient department for various indications of circumcision were enrolled on the basis of a predefined inclusion and exclusion criteria. The subjects were randomized and allocated into two groups, group PD and group CDS. Group PD was subjected to circumcision by Plastibell device technique. Group CDS was subjected to circumcision by conventional dissection technique. Duration of the circumcision and intra-operative complications if any were recorded, from starting the retraction of prepuce to completion of the procedure. Early and late complications were also compared during fo...
Introduction: Circumcision is the commonest surgery performed in the Muslims. In our country circum- cision is performed by barbers, medical technicians, quacks and doctors including paediatric surgeon. As yet there is no consensus for the best age and method for circumcision. Aim: To evaluate the safety of various methods of circumcision at different age groups and to suggest the best age & method of circumcision. Design and Method: A retrospective study was conducted to review the 316 consecutive circumcision performed by the author at Shifa International Hospital Islamabad from June 1998 to September 2001. All babies & children who underwent circumcision by the author were included in the study. Babies having circumcision as a part of hypospadias repair were excluded. Circumcision below two year was done by plastibell under local anaesthesia and circumcision above two years was performed by open technique under general anaesthesia. Results: Of the 316 circumcisions 227 (72%) were...
INTERNATIONAL JOURNAL OF ANATOMY RADIOLOGY AND SURGERY, 2021
Introduction: Circumcision is most often an elective surgery performed on babies and children, for religious or cultural reasons. In other cases, it may be done as a treatment for certain medical conditions or for preventive reasons. Circumcision is done in cases of phimosis, balanoposthitis and chronic Urinary Tract Infections (UTIs). Various techniques are available for circumcision (Plastibell, Gomco clamp, Mogen clamp, etc.,). However, the practices and procedures of circumcision and complications of various procedures are not well documented. The conventional or plastibell device method is one of the methods most frequently employed for circumcision. Aim: To compare the outcome of circumcision done by conventional technique against plastibell methods. Materials and Methods: This was a retrospective observational study conducted from May 2017 to January 2019 in the Department of Surgery at LG Hospital, AMC MET Medical College, Ahmedabad. Study included 60 male patients younger t...
African Journal of Urology
Background Circumcision has been practiced since antiquity and is one of the most commonly performed surgical procedures. The aim of the study was to compare the efficacy and safety of the two most common techniques: Freehand and Plastibell techniques of circumcision. Methods The study was a prospective randomized study that was conducted on uncircumcised males at or below the age of 5 years that presented for circumcision. All boys who satisfied the inclusion criteria and whose parents consented, were randomized into two groups. Group A had freehand circumcision, while Group B had Plastibell circumcision. Patients were followed up at day 7 and day 28 postoperatively. The variables compared were operating time, cost, complications and parents’ satisfaction. All the data obtained were entered into a proforma. The data obtained were analyzed using SPSS version 20. Results A total of 110 boys were circumcised, 55 boys in each group. The median ages in the Plastibell and freehand groups...
A Trade-Off Analysis of Routine Newborn Circumcision
Obstetrical & Gynecological Survey, 2000
Background. The risks associated with newborn circumcision have not been as extensively evaluated as the benefits. Objectives. The goals of this study were threefold: 1) to derive a population-based complication rate for newborn circumcision; 2) to calculate the number needed to harm for newborn circumcision based on this rate; and 3) to establish trade-offs based on our complication rates and published estimates of the benefits of circumcision including the prevention of urinary tract infections and penile cancer. Methods. Using the Comprehensive Hospital Abstract Reporting System for Washington State, we retrospectively examined routine newborn circumcisions performed over 9 years (1987-1996). We used International Classification of Diseases, Ninth Revision codes to identify both circumcisions and complications and limited our analyses to children without other surgical procedures performed during their initial birth hospitalization. Results. Of 354 297 male infants born during the study period, 130 475 (37%) were circumcised during their newborn stay. Overall 287 (.2%) of circumcised children and 33 (.01%) of uncircumcised children had complications potentially associated with circumcision coded as a discharge diagnosis. Based on our findings, a complication can be expected in 1 out every 476 circumcisions. Six urinary tract infections can be prevented for every complication endured and almost 2 complications can be expected for every case of penile cancer prevented. Conclusions. Circumcision remains a relatively safe procedure. However, for some parents, the risks we report may outweigh the potential benefits. This information may help parents seeking guidance to make an informed decision. Pediatrics 2000;105:246-249; newborn circumcision, complications, urinary tract infections.