Parental evaluation of postoperative outcome of circumcision with Plastibell or conventional dissection by dorsal slit technique: a randomized controlled trial

Abstract

Aim: To evaluate and compare parental satisfaction after Plastibell and conventional dissection circumcision.

Methods: 198 children were randomly and equally allocated to two groups (PD: Plastibell and CDS: dissection) for circumcision. Follow-up was done at 7th, 15th and 90th day after surgery. Written questionnaires were given to parents at the time of discharge to complete and return at the 15th and 90th day follow-up visits.

Results: Both groups were balanced with respect to various demographic factors, indications for surgery and Kayaba's classification of the prepuce. Surgical duration was significantly shorter for the PD as compared to the CDS group (5.91 ± 1.74 min vs. 23.52 ± 5.94 min; p < 0.0001 H.S.). Swelling, dysuria and infection were the prominent problems reported in both groups in the first 7 days. The Plastibell separated earlier in younger children (p < 0.0001). Postoperatively, children in the PD group required 2.79 fold more analgesic than those in the CDS group. 97.9% of parents in the PD group and 80.2% of parents in the CDS group claimed satisfactory aesthetic results. The PD group parents were statistically significantly more concerned about swelling.

Conclusions: Plastibell use has comparable outcomes to the conventional dissection technique for paediatric circumcision and has an obvious advantage of shorter surgical duration. However, it is less comfortable in the postoperative period due to swelling, and requires greater use of analgesics.

Keywords: Circumcision; Conventional dissection; Paediatric; Plastibell device.