Circumplast vs Plastibell complications ESPU 2016

By john@ergodigital.com,

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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 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 & 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).
  • Delayed ring separation/migration is significantly lower in CC (3.2% n=7/208) versus PC (8.7% n=102/1179).
  • 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.
  • In children under 6 months, the overall outcome in both groups is significantly better in comparison to 6 – 110 months old.
  • 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.

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”

Slide Show of the Presentation