Iftikhar Ahmad Jan.
Circumcision in babies and children with Plastibell technique: an easy procedure with minimal complications - Experience of 316 cases.
Pak J Med Sci Jan ;20(3):175-80.

Introduction: Circumcision is the commonest surgery performed in the Muslims. In our country circumcision is performed by barbers, medical technicians, quacks and doctors including paediatric surgeon. As yet there is no consensus for the best age and method for circumcision. Aim: To evaluate the safety of various methods of circumcision at different age groups and to suggest the best age Et method of circumcision. Design and Method: A retrospective study was conducted to review the 316 consecutive circumcision performed by the author at Shifa International Hospital Islamabad from June 1998 to September 2001. All babies £t children who underwent circumcision by the author were included in the study. Babies having circumcision as a part of hypospadias repair were excluded. Circumcision below two year was done by plastibell under local anaesthesia and circumcision above two years was performed by open technique under general anaesthesia. Results: Of the 316 circumcisions 227 (72%) were performed in the first week of life by the plastibell. 17 (5%) children had circumcision from 2-12 years of age mostly by open method. Overall incidence of complications was 2 % (7 patients). Two had bleeding from the circumcision site which was controlled by local measures. Bell impaction was seen in two patients at 1.6 years Et 3 years age and parents of two babies were concerned about inadequate circumcision. Circumcisions performed in the neonatal period had minimal number of complications. Conclusion: Circumcision can be safely performed in a hospital set-up within first month of life preferably in the first week if the baby is otherwise well. Plastibell is a safe method for babies under one year. Older children should have circumcision by open method. Plastibell can be a safe technique if performed by trained GPs under aseptic conditions.

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