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S15-6
(P)
CIRCUMCISION WITH A NOVEL DISPOSABLE RING - CIRCUMPLAST®. DOES THIS
NEW DESIGN PREVENT RING MIGRATION AND GLANS PENIS INCARCERATION?
Abdul Rauf KHAN
Thornhill Circumcision Clinic, Bedfordshire, England, UK, General Practice clinic, Luton, UNITED KINGDOM
PURPOSE
Ring impaction/proximal migration of Plastibell is the most common complication in male circumcision. This can cause
incarceration of the glans and urethral damage. This study evaluates our experience using Circumplast
®
device for male
circumcision.
MATERIAL AND METHODS
Circumplast
®
was used to perform non-therapeutic circumcisions on 112 male children between April 2013 and March
2014. The procedures were performed at a community clinic under local anaesthesia by the trained paediatric
surgeon. Data were prospectively collected to determine the post-operative complications. All patients were contacted
on 10
th
and 15
th
day to determine ring separation. A similar study was conducted using the Plastibell
®
method on 1883
patients over a one year period in the same clinic. All calls/visits from parents were registered on the Audit Monitoring
system.
RESULTS
Average age of patients was 2.9 years (range, 7 days to 11 years) and median age was 5 months. Patients (n=111) had
spontaneous ring separation. Delayed separation of the ring in a 9 year old patient required ring removal as the ring had
not come off on day 15 post-operatively due to inadequate size of ring when compared to glans penis. Using the
Plastibell
®
method on 1883 patients over a one year period resulted in delayed/partial ring separation or proximal
migration in 2.1% (n=40) of patients. Due to Circumplast’s
®
cylindrical design, there is no risk associated with the glans
moving distally as there are no obstructions. In contrast, the Plastibell™ ring is conical with a narrowed distal end and
the glans is held against the distal opening which causes the glans to protrude through this opening. Circumplast allows
for multiple locations to secure the ligature and easy access to the glans and frenulum postoperatively.
CONCLUSIONS
The Circumplast
®
device with a cylindrical design virtually eliminates the risk of migration/impaction of the ring to the
shaft of the penis in our experience of 112 circumcisions.