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Prospective randomized trial comparing dissection with Plastibell® circumcision

José Murillo Bastos NettoabeCorresponding Author Informationemail address, José Gonçalves de Araújo Jr.c, Marcos Flávio de Almeida Noronhac, Bruno Rezende Passosc, José de Bessa Jr.d, André Avarese Figueiredoae

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

a Federal University of Juiz de Fora – Department of Morphology, Brazil

b Faculdade de Ciências Médicas e da Saúde de Juiz de Fora – SUPREMA, Department of Urology, Brazil

c Federal University of Juiz de Fora – Department of Urology, Brazil

d State University of Feira de Santana – Division of Urology, Brazil

e University Hospital of the Federal University of Juiz de Fora – Department of Urology, Brazil

Corresponding Author InformationCorresponding author. Av. Rio Branco, 2985/sl. 605, Juiz de Fora – MG, 36010-012 Brazil. Tel./fax: +55 32 3218 9899.

PII: S1477-5131(10)00008-2

doi:10.1016/j.jpurol.2010.01.005