Plastibell circumcision: A minor surgical procedure of major importance

Objective: To determine the number of days taken by the Plastibell to fall off after circumcision and the Plastibell impaction rate in various age groups. Methods: This was a prospective cohort study of male babies who underwent circumcision using the Plastibell technique. Patients were followed up 1 week postoperatively as well as soon after the Plastibell had fallen off. Results: Mean age was 14.3 months and mean weight 8.2 kg at time of surgery. The average time taken for the Plastibell to fall off after circumcision for babies under 3 months was 8.7 days; this period gradually increased to 16.8 days for children over 5 years of age. The overall complication rate was 7.4%. Plastibell impaction was the commonest complication, encountered after 6.1% of procedures, and was managed by cutting the Plastibell. The impaction rate was only 2.3% for babies under 3 months, but gradually increased to 26.9% for children over 5 years. Conclusion: The time taken by the Plastibell to fall off spontaneously as well as the Plastibell impaction rate increases gradually with age. In view of the overall safety, comfort and absence of any long-term complication, this procedure justifies recommendation in all children aged under 1 year, but its use is debatable in older children. (C) 2009 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.