Plastibell Circumcision for Children

Circumcision is a short procedure performed to remove the foreskin on the penis. The reason for getting the foreskin removed vary and may include cultural or religious beliefs, health awareness, partner preferences etc. Certain health benefits of getting circumcised include reduced risk of penile cancer (no chance for deposition of smegma under the foreskin after it is removed), reduced risk of STI/STD transmission, reduced risk of UTI (Urinary Tract Infections) etc. 

Types of circumcision

Circumcision can be performed in different ways. Some of the popular types of procedures are:

1. Plastibell method or ring method
2. Morgen Clamp technique
3. Stapler Circumcision
4. Gomco clamp method

Out of these, plastibell and stapler circumcision are very popular and most performed by specialists. Many doctors recommend plastibell circumcision for children and here, let’s take a detailed look at how the procedure is done and the benefits of plastibell circumcision technique.

Steps involved in performing plastibell circumcision technique

1. The child or infant is made to lie on his back.
2. Numbing cream is applied to the phallus or lidocaine solution is injected near the foreskin.
3. Once the anaesthesia takes effect, the foreskin is stretched/pulled over the penis head.
4. A dorsal slit is made to the foreskin.
5. A plastibell (device that is shown in the picture) of appropriate size is inserted into the foreskin and placed over the head of the penis. This is a very important step. The plastibell has to be well placed to cut the foreskin to the right level.
6. Once the plastibell is in place, a string is taken and wound around the penis head (over the foreskin). A slot-like place exists on the plastibell which can hold the string. In effect, the foreskin that is sleeved onto the plastibell is tightly tied with the string so that there is no blood flow beyond that point to the tip of foreskin.
7. The foreskin above the string area is cut completely leaving just a little bit of skin above the string.
8. The area is bandaged neatly and parents will be advised to avoid contact with water for a couple of days.
9. As no blood flows into the remaining part of the foreskin, the small leftover portion of the skin falls off in about 2 weeks and then the string and part of the plastibell is removed.

Benefits of plastibell technique

1. Minimal blood loss – As the foreskin is tied with the string, no blood flows out even after cutting the foreskin. It’s just when making the dorsal slit, blood can be seen.
2. Plastibell circumcision technique doesn’t take much time, similar to ZSR stapler circumcision, this is a simpler and precise technique.
3. Plastibell method (or ring circumcision method) has shown lower complication rate and higher satisfaction of patients and doctors.

Risks of plastibell circumcision technique

1. Possibility of infection – Like any surgery that involves incision or cutting any part of the skin or body, there is a possibility of infection. The risk is manageable with antibiotics if the doctor feels necessary.
2. Improper circumcision – If the plastibell isn’t placed properly onto the penis head, right amount skin may not be removed and that may require another round of circumcision.

Taking care of infants and children after circumcision

1. In case of infants, diapers need to be checked more frequently and changed when the baby pees or passes stool.  Keeping the bad diaper on for longer can cause infections at the surgical site.
2. Avoid contact with water for a couple of days to prevent any possible infection.
3. Should you see any liquid draining that is associated with pain or inflammation, you must consult your doctor.
4. Watch out for the string and the last piece of string to fall off after a week post surgery.
5. If your doctor has put the baby or child on antibiotics, follow the prescription without fail.

References:

1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3253617/