The Proximal Migration of Plastibell Ring In Appropriate-Size Plastibell Circumcision Vs One-Size-Smaller Plastibell Circumcision

Proximal migration of plastibell ring in circumcision

Abstract

Background: Circumcision is the oldest known and commonly performed surgery in various communities worldwide, and plastibell circumcision remains the most commonly performed procedure now a days. However, the plastibell method is not without controversies.

Aims: This study aims to see the impact of size of the plastibell in proximal migration of the ring, performed with an appropriate-size plastibell device versus a one-size-smaller plastibell device.

Methods: A prospective comparative study was conducted at the Surgery and Urology Departments of Fauji Foundation Hospital, Lahore for a period of 11 months (February 2024 to December 2024) after approval from the Ethical Review Committee (FFH/STATE/FIL/20). Male neonates and infants up to 6 months of age were enrolled and divided into two groups: Group A with appropriate-size plastibell circumcision and Group B with one-size-smaller plastibell circumcision. Patients were followed up for 1 week. Statistical analysis of data was performed by using SPSS Version 23. P-value was considered a significant difference at <0.05.

Results: 209 patients were included in this study. Proximal migration of bell was noted in total 12 cases, out of which 10 cases were in appropriate-sized plastibell group (Group A) and 2 cases were in one-size-smaller plastibell group (Group B). Bleeding was noted in total 6 cases, out of which 4 cases were in appropriate-size plastibell group (Group-A) and 2 cases were in one-size smaller plastibell group (Group-B). Number of days taken for the spontaneous fall of the bell was more in one-size-smaller plastibell group (Group-B) compared to appropriate-size plastibell group (Group-A).

Conclusion: This study demonstrates that one-size-smaller plastibell device is safer compared to appropriate-size plastibell device regarding bell impaction.