Non-therapeutic male circumcision in children with a novel disposable ring – Circumplast improves the outcome as compared to the standard Plastibell device at a community clinic.
This cohort study evaluates the early postoperative complications in Circumplast and Plastibell techniques, in a community clinic, for non-therapeutic male circumcision.
Material & Methods
We reviewed outcomes of non-therapeutic male circumcision in 1,387 children over a year (May 2014 to April 2015) in a community clinic. Procedures were performed under local anaesthesia by trained doctors, with backup from a trained paediatric surgeon. Technique selection was based on doctor preference. Data was collected prospectively and early postoperative complications were compared between Circumplast and Plastibell circumcisions. Follow-up consultations were arranged as needed.
Results
- Mean Age: 18 ± 1.9 months (median 5.1) for Circumplast circumcision (CC) vs 9.4 ± 0.6 months (median 1.5) for Plastibell circumcision (PC).
- Complication Rates: Significantly lower in CC (6.3%, n=13/208) compared to PC (13%, n=154/1179).
- Delayed Ring Issues: Significantly lower in CC (3.2%, n=7/208) vs PC (8.7%, n=102/1179).
- Other Complications: Post-operative bleeding (0.5% vs 0.6%), preputial adhesions (1.4% vs 2.4%), and miscellaneous complications (0.5% vs 1%) were lower in CC but not statistically significant.
- Antibiotic Use: Higher in CC (6.7%) vs PC (3.8%) but not statistically significant.
- Age Impact: Better outcomes in children under 6 months compared to older age groups.
- Follow-up: Mean follow-up consultations at 19 days (range 1-373) for CC and 20 days (range 1-305) for PC.
Conclusion
Non-therapeutic male circumcision using the Circumplast device shows a significantly lower risk of early postoperative complications, particularly regarding ring migration or impaction, compared to the standard Plastibell device in a community clinic setting.
Comment by the clinic:
“This is our latest audit from Thornhill Circumcision Centre. This audit was presented by one of our doctors in the meeting of paediatric urologists at Harrogate, Yorkshire, UK on 23 June 2016 at the congress”