Proximal Migration of Plastibell Ring in Appropriate-Size Plastibell Circumcision vs One-Size-Smaller Plastibell Circumcision

Ring Migration: Appropriate vs Smaller Plastibell

Abstract

Background: Circumcision is one of the oldest and most extensively executed surgeries worldwide, with Plastibell being the most common technique, though not without controversies. Objective: This study aims to see the impact of the size of the Plastibell in proximal migration of the ring, performed with an appropriate-size Plastibell device versus a one-size-smaller Plastibell device. Study Design: Prospective comparative study. Settings: Surgery and Urology Departments of Fauji Foundation Hospital, Lahore Pakistan. Duration: 11 months (February 2024 to December 2024). Methods: Male neonates and infants up to 6 months 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. Data were analyzed using SPSS v23, with significance at p<0.05. Results: Out of 209 patients, proximal bell migration occurred in 12 cases—10 in the appropriate-size group and 2 in the smaller-size group. Bleeding occurred in 6 cases—4 in the appropriate-size group and 2 in the smaller group. Bell separation took longer in the one-size-smaller group. Conclusion: This study demonstrates that a one-size-smaller Plastibell device is safer compared to an appropriately sized Plastibell device regarding bell impaction.