Plastibell and Conventional Circumcision in Infants: a Randomized Clinical Trial

Conventional dissection suturing technique and Plastibell circumcision are the two most widely used methods of circumcision in Iran. We conducted a clinical trial to assess the complication, cosmetic results, and duration of the procedure using the two techniques. 2185 infants under the age of one were circumcised at two hospital centers, from April 2000 to March 2003. The infants were randomized to one of two groups group A, using the plastibell device (n=1085), and group B, using the conventional technique (n= 1100). All infants received dorsal nerve block with Lidocaine 2%. The two groups were evaluated for complications and cosmetic results immediately follwing the operation and 4-10 days later. The parents were told to notify the surgeon if meatal stenosis occurs. Comparisons were made regarding the complications, cosmetic results, and duration of the procedure. The incidence of bleeding in the plastibell group (A) was 3 infants (0.3%), significantly less than the convention group (B) which was 11 infants (1.0%)(p=0.030). In group A, local infection resulting in further surgery did not occur, but 3 infants (0.3%) in group B needed further surgery due to local infection (p=0.127). The Plastibell circumcision resulted in poor cosmetic results for 3 infants (0.3%) compared to 9 infants (0.8%) in the conventional group (p=0.076). The mean operation time (± SD) was shorter for Plastibell circumcision (4.08± 0.81 vs 18.13± 1.87 minutes). We recommend circumcision for infants using the Plastibell technique, because of the results of this study which indicated less complications and shorter duratrion.