A Prospective Study of Circumcision by Plastibel Technique in Neonates and Infants

Abstract

Background: Male circumcision (MC) is among the oldest surgical procedures, historically practiced across several continents for cultural, religious, and medical reasons. Plastibel circumcision has gained popularity due to its relative simplicity, reduced complication profile, and suitability for use under local anesthesia. Despite these advantages, complications such as bleeding, infection, and delayed plastibel separation are reported. Neonates are believed to experience fewer complications and faster recovery due to thinner prepuce and simpler anatomy compared with older infants.

Methods: We conducted a prospective study of 488 neonates and infants undergoing plastibel circumcision for cultural or religious indications at the Department of General Surgery, Basaveshwar Teaching and General Hospital, attached to M.R. Medical College, Kalaburagi, between January 2023 and March 2024. Children with congenital penile abnormalities, deranged coagulation profiles, or unstable medical conditions were excluded. Perioperative details including operation time, plastibel device separation day, and postoperative complications were recorded. Follow-up visits were scheduled on post-procedure day 3 and the day of plastibel separation.

Results: Of 488 participants, 66 (13.52%) were neonates and 422 (86.47%) were infants. Mean operative time was 6±2 minutes, and the plastibel fell off at a mean of 6.2 days (range 3–12 days). Neonates showed a shorter mean ring separation time compared with older infants. Successful plastibel circumcision without complications was observed in 408 (83.6%) cases, while 80 (16.4%) experienced minor complications. Delayed ring separation and mild bleeding were the most commonly observed adverse events.

Conclusion: Plastibel circumcision in neonates and infants is a safe, quick, and effective procedure with a favorable complication profile. Neonates generally demonstrate fewer complications and earlier ring separation than older infants, underscoring the potential benefits of early circumcision.