Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 May;35(5):619-623.
doi: 10.1007/s00383-019-04452-x. Epub 2019 Feb 14.

Avoidance of general anesthesia for circumcision in infants under 6 months of age using a modified Plastibell technique

Thanh Tam Nguyen  1 , Elizabeth Kraft  2 , Ziyad Nasrawi  2 , Minal Joshi  2 , Demetri Merianos  2
Affiliations

Avoidance of general anesthesia for circumcision in infants under 6 months of age using a modified Plastibell technique

Thanh Tam Nguyen et al. Pediatr Surg Int. 2019 May.

Abstract

Purpose: There is currently no gold standard for the type of analgesia or preferred circumcision technique in infants requiring circumcision after 1 month of age. Our study presents a modified Plastibell circumcision technique, which offers excellent surgical outcomes, and can be performed under local anesthesia until 6 months of age, thereby avoiding the risks of general anesthesia in delayed circumcision.

Methods: This is a retrospective case series of 508 consecutive male infants between 1 and 6 months of age, from one institution, who all underwent circumcision under local anesthesia, performed by the same pediatric surgeon, from 2013 to 2018. The study parameters included postoperative complications such as re-operation for control of hemorrhage, wound infection, circumcision revision, and urethral meatotomy.

Results: There were no re-operations for control of hemorrhage, no wound infections, and no circumcision revisions. One patient developed urethral meatal stenosis requiring urethral meatotomy.

Conclusion: Our modified Plastibell circumcision technique under local anesthesia is a safe and reproducible alternative for infants between 1 and 6 months of age, whose parents desire circumcision and wish to avoid general anesthesia.

Keywords: Circumcision; Infants; Local anesthesia; Modified Plastibell technique; Risks of general anesthesia..

PubMed Disclaimer

Conflict of interest statement

Conflict of interest

None.

Research involving human participants and/or animals

All procedures performed in this study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed consent

All informed consents were obtained from guardians/parents of all infants in this study.

Figures

Fig. 1
Fig. 1
a Dorsal slit. b Plastibell placement. c Foreskin Division. d Dorsal and Ventral Stitches. e Complete circumcision
See this image and copyright information in PMC

References

    1. DeFrances CJ, Cullen KA, Kozak LJ, National Hospital Discharge Survey 2005 annual summary with detailed diagnosis and procedure data. Vital Health Stat. 2007;13:1–209. - PubMed
    1. Sun L. Early childhood general anaesthesia exposure and neurocognitive development. BJA. 2010;105(supplement 1):i61–i68. doi: 10.1093/bja/aeq302. - DOI - PMC - PubMed
    1. Pfuntner A, Wier LM, Stocks C (2011) Most frequent procedures performed in US Hospitals, HCUP statistical brief #165. October 2013. Agency for healthcare research and quality, Rockville, MD. https://www.ncbi.nlm.nih.gov/books/NBK174682/. Accessed 13 Oct 2018
    1. Cott CJ. A practice of anesthesia for infants and children. A practice of anesthesia for infants and children. PA, USA: Philedelphia; 2009.
    1. Sanders RD, Hassell J, Davidson AJ, Robertson NJ, Ma D. Impact of anaesthetics and surgery on neurodevelopment: An update. Br J Anaesth. 2013 - PMC - PubMed

LinkOut - more resources