Abstract
INTRODUCTIONThe plastibell device is used successfully for religious and cultural circumcisions in the community. The aim of this article is to highlight the recognition and management of iatrogenic phimosis.METHODSA retrospective study was performed of outcomes of plastibell circumcision in a community-based circumcision service provided by trained paediatric surgeons. The objective was to assess the complication of slipped plastibell rings and to ascertain the effectiveness of its management.RESULTSA total of 5 patients with a slipped plastibell ring were indentified out of 560 plastibell circumcisions. Three patients presented with acquired phimosis. In two patients early diagnosis and management prevented any further complications and a second operation was avoided.CONCLUSIONSPlastibell circumcision in the community is safe and effective. Detection of minor bleeding due to a slipped ring is important. Early management can avoid the risk of acquired phimosis due to cicatrix formation and can save parents of undue anxiety.
Highlights
The plastibell device is used successfully for religious and cultural circumcisions in the community
The aim of this article is to highlight that early detection of the misalignment of the inner foreskin and outer layer can prevent the formation of iatrogenic phimosis
Five patients developed complications of a slipped ring and all were managed at different stages of this complication
Summary
The plastibell device is used successfully for religious and cultural circumcisions in the community. The aim of this article is to highlight the recognition and management of iatrogenic phimosis. The objective was to assess the complication of slipped plastibell rings and to ascertain the effectiveness of its management. RESULTS A total of 5 patients with a slipped plastibell ring were indentified out of 560 plastibell circumcisions. In two patients early diagnosis and management prevented any further complications and a second operation was avoided. CONCLUSIONS Plastibell circumcision in the community is safe and effective. Detection of minor bleeding due to a slipped ring is important. Management can avoid the risk of acquired phimosis due to cicatrix formation and can save parents of undue anxiety
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