CIRCUMCISION WITH A NOVEL DISPOSABLE RING
Javaria Akram
CIRCUMPLAST®. DOES THIS NEW DESIGN PREVENT RING MIGRATION AND GLANS PENIS INCARCERATION?
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
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.
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.