Prospective randomized trial comparing dissection with Plastibell® circumcision

Bastos Netto, José Murillo; de Araújo, José Gonçalves; de Almeida Noronha, Marcos Flávio; Passos, Bruno Rezende; de Bessa, José; Figueiredo, André Avarese

doi:10.1016/j.jpurol.2010.01.005

« Previous Next »Journal of Pediatric Urology
Volume 6, Issue 6 , Pages 572-577, December 2010

Prospective randomized trial comparing dissection with Plastibell^® circumcision

José Murillo Bastos Netto
- Federal University of Juiz de Fora – Department of Morphology, Brazil
- Faculdade de Ciências Médicas e da Saúde de Juiz de Fora – SUPREMA, Department of Urology, Brazil
- University Hospital of the Federal University of Juiz de Fora – Department of Urology, Brazil
- Corresponding author. Av. Rio Branco, 2985/sl. 605, Juiz de Fora – MG, 36010-012 Brazil. Tel./fax: +55 32 3218 9899.
José Gonçalves de Araújo Jr.
- Federal University of Juiz de Fora – Department of Urology, Brazil
Marcos Flávio de Almeida Noronha
- Federal University of Juiz de Fora – Department of Urology, Brazil
Bruno Rezende Passos
- Federal University of Juiz de Fora – Department of Urology, Brazil
José de Bessa Jr.
- State University of Feira de Santana – Division of Urology, Brazil
André Avarese Figueiredo
- Federal University of Juiz de Fora – Department of Morphology, Brazil
- University Hospital of the Federal University of Juiz de Fora – Department of Urology, Brazil

Received 23 August 2009; accepted 7 January 2010. published online 15 February 2010.

Abstract

Objective

To compare and evaluate dissection and Plastibell^® circumcision techniques for the treatment of phimosis.

Methods

In 2006–2007, 125 children were submitted to circumcision by the same surgeon. The children were randomly divided into two groups (PD: Plastibell^® and DC: dissection). In both groups the surgery was performed under general anesthesia and dorsal penile block. The dissection circumcision used the double circular incision technique. Follow-up was done on days 15, 45 and 90 after surgery.

Results

Sixty-eight patients were included in DC and 57 in PD. The mean age at surgery was 71.76 ± 31.56 months for DC and 70.95 ± 31.73 months for PD. There was no difference in Kayaba's classification for phimosis or indication for surgery between the groups. Surgical time for DC was 14.64 ± 1.93 min and for PD 3.29 ± 1.48 min (P < 0.001). The incidence of immediate complications was similar, but late complications, especially adhesions, were greater in DC (P < 0.01). The use of pain medication (paracetamol) was similar during the first 2 days after surgery, but was greater in PD from the 3rd day after surgery (P < 0.05).

Conclusions

Plastibell^® circumcision has a shorter surgical duration with fewer late complications, but requires more analgesic medication after the 3rd day post surgery.

Keywords: Circumcision, Phimosis, Plastibell, Children