Original Article

A quasi-experimental study comparing outcomes and parents’ response in 600+ circumcised boys in a Lower-Middle Income Country

Abstract

• Background: Circumcision is one of the most common elective surgical procedures amongst Muslim. Plastibell is now gaining popularity as it is much safer with lower complication rate. Objective: To compare the Open and Plastibell method of circumcision in terms of procedural time, outcomes and parental satisfaction. Methods: This quasi-experimental study included boys up to 5 years of age who were categorized into Open method and Plastibell based on parental preference. Follow-up occurred on the 5th, 10th and 30th post-procedural day. Basic demographic data, procedural duration, and outcomes were documented. Results: Of 646 boys brought to the hospital for circumcision, 608 met the inclusion criteria with equal participants in both groups. The median age in Open and Plastibell groups was three and five months respectively. The median operating time was significantly shorter in the Plastibell group (4.2 min) compared to the Open method (13 min). Of the 91 cases of complications, 61 were observed in Plastibell group. Post-procedure bleeding occurred in 1.2% children. Commonest complications in open method included infection, excessive skin removal (n=8 each), and urinary retention (n=7) whereas Plastibell impaction (n=21) and inadequate skin removal (n=19) were observed in the Plastibell group which were significantly associated with older boys. There were no serious adverse events. Open method was preferred by parents for cosmesis and Plastibell for ease of care. Conclusion: Plastibell, compared to open method, is a quicker and safer method of circumcision for boys up to 5years of age, however, earlier circumcisions are associated with lesser complications.
  
  

• Keywords: Circumcision, Open method, Plastibell, complications, outcomes

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