Plastibell Circumcision Method vs Conventional Circumcision Method in Terms of Operative Outcomes in Paediatric Patients- A Retrospective Study

Abstract

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 than 10 years that underwent circumcision by either conventional method or plastibell method for various indications. Circumcision done for congenital abnormalities like hypospadias, epispadias, webbed penis etc., deranged coagulation profile i.e., bleeding or clotting disorders were excluded from study. The data of 30 children that underwent circumcision with conventional method (Group A) and 30 children with plastibell method (Group B) was collected. The follow-up data like wound at the operative site or any complaints or complications were also recorded. Paired t-test and Chi-square test were used to compare collected data for significance. Results: The most common indication for circumcision in this study was phimosis (n=58, 96.67%). The mean age was 4.80±2.30 years (0 to 10 years). The mean surgical time was 10.17±1.82 minutes with estimated blood loss of 11.70±2.98 mL in plastibell method while it was 19.73±2.39 minutes and 24.80±4.01 mL, respectively in conventional method (p<0.0001). The most common complication was localised superficial infection in both groups, two patients (6.66%) in plastibell method while one patient (3.33%) in conventional method. The overall postoperative complication rate was more in plastibell method compared with conventional method (20% vs 3.33%, p=0.04). Conclusion: It was concluded that plastibell method has surgical advantages in children below 10 years even though higher complication rate compare to conventional method due to negligible chance of serious complications and shorter duration of surgery with less amount intraoperative bleeding compared to conventional method.