Dr Khan presented this study the annual congress of European Society Pediatric Urologists at Herrogate, England, UK

PURPOSE

This cohort study will evaluate the early postoperative complications in Circumplast® and Plastibell®techniques, in a community clinic, for non-therapeutic male circumcision at Thornhill clinic and Leyton clinic. 

MATERIAL AND METHODS

We reviewed the outcome of non-therapeutic male circumcision in children (n=1387) over a 1 year period (May 2014 to April 2015) in a community clinic, performed under local anaesthesia, by trained doctors with the backup of a trained paediatric surgeon. The technique was selected by doctors’ preference. Data was collected prospectively and early postoperative complications were compared between Circumplast® and Plastibell® circumcisions. Follow-up consultations were arranged if required.

RESULTS

The mean age was 18 ± 1.9 months (median 5.1) in Circumplast® circumcision (CC) and 9.4 ± 0.6 months (median 1.5) in Plastibell® circumcision (PC). Incidence of complications is significantly lower in CC (6.3% n=13/208) versus PC (13% n=154/1179) (p<0.05). Delayed ring separation/migration is significantly lower in CC (3.2% n=7/208) versus PC (8.7% n=102/1179) (p<0.05). Post-operative bleeding (0.5% vs 0.6% n= 1 vs 7), preputial adhesions (1.4% vs 2.4% n= 3 vs 28), and miscellaneous complications (0.5% vs 1% n= 1 vs 13) were lower but not statistically significant (p>0.5) in CC versus PC respectively. Postoperative use of antibiotics was higher in CC versus PC (6.7% vs 3.8% n=14 vs 45) but not statistically significant (P>0.05). In children under 6 months, the overall outcome in both groups is significantly better in comparison to 6 - 110 months old (p<0.05). Mean follow-up consultations were 19 days (range 1 to 373) in CC and 20 days (range 1 to 305) in PC.

CONCLUSIONS

Non-therapeutic male circumcision by the Circumplast® device has a significantly lower risk of early postoperative complications in a community clinic, especially migration/impaction of the ring when compared to the standard Plastibell® device.

source: ESPU 2016 website.