Parental circumcision preferences and early outcome of plastibell circumcision in a Nigerian tertiary hospital

Abstract

Background:Parents are central in decisions and choices concerning circumcision of their male children and plastibell circumcision is a widely practiced technique. This study determined parental preferences for male neonatal and infant circumcisions and evaluate the early outcomes of plastibell circumcisions in a tertiary centre.Patients and Methods:This is a prospective study on consecutive male neonates and infants who were brought for circumcisions at Nnamdi Azikiwe University Teaching Hospital Nnewi, South-East Nigeria and their respective parents between January 2012 and December 2012. Data on demography, parental choices and early outcome of plastibell circumcision were obtained and analysed.Results:A total of 337 requests for circumcisions were made for boys with age range of 2-140 days. Culture and religion were the most common reasons for circumcision requests in 200 (59.3%) and 122 (36.2%), respectively, other reasons were medical, cosmesis, to reduce promiscuity and just to follow the norm. Most parents, 249 (73.9%) preferred the procedure to be performed on the 8th day and 88.7% would like the doctors to perform the procedure while 84.6% preferred the plastibell method. Among those who had circumcision, 114 complied with follow-up schedules and there were complications in 22 (19.3%) patients. Parents assessed the early outcome as excellent, very good, good and poor in 30.7%, 45.6%, 18.4% and 5.3% of the patients, respectively.Conclusion:Parents request for male circumcision in our environment is largely for cultural and religious reasons; and prefer the procedure to be performed by a physician. Plastibell method is well known and preferred and its outcome is acceptable by most parents.

Bone cutter versus plastibell device in neonatal circumcision: A randomized trial

“…In our clime, most circumcision is performed by traditional circumcisionists, traditional birth attendants, nurses, and hospital ward attendants, sometimes with major complications such as urethrocutaneous fistula, excessive post circumcision bleeding, and glans amputation. [5,17,19,26,27] The result of our study showed that the bone cutter method performed better than the plastibell method in terms of the average amount of blood loss and duration of surgery. The Hollander wound evaluation scale and parental satisfaction as measured by the penile perception score were similar in both groups, even though the level of parental satisfaction was higher among those who had bone-cutter technique.…”

“…Many studies suggested that plastibell circumcision is a simple method and minor complications include local sepsis, bleeding, bell impaction, dysuria, incomplete separation of plastibell device, proximal migration of the ring, and excessive or inadequate skin removal. [17,23,29] However, case series of significant complications have also been reported. This includes necrotizing fasciitis, urinary retention, and glans necrosis.…”

“…[13,16] The Plastibell device was first described in 1956 in the USA by Kariher and Smith and has since become very popular, widely preferred by parents, and practiced due to its ease of application, safety, less blood loss, and shorter duration of the operation. [17][18][19][20] However, complication rates of 6% to 20% have been documented. [20,21] In contrast, the bone cutter is used commonly in the Middle East for newborn circumcision.…”

Comparison of the efficacy and safety of circumcision by freehand technique and Plastibell device in children

“…They adduced the study findings to the settings (Abuja and Lagos) in which preponderance of the patients were Yorubas and Ibos, who typically circumcise their children earlier and often within the first few days of life. Ekwunife et al [6] in a study conducted at Nnamdi Azikwe University Teaching Hospital, Nnewi (southeastern Nigeria), reported an age range of 2-140 days, and 73.9% of the parents would prefer circumcision to be carried out on the 8th day of life.…”

Plastibell: A Safe Technique of Circumcision

“…Circumcision is surgical removal of prepuce that covers the glans penis 5 Circumcision is a desirable public health intervention and an old custom being practiced in various communities for a long time. [1][2][3][4][5][6][7][8][9][10][11][12][13][14] It is one of the most common male surgical procedure performed globally with one in three males circumcised worldwide. It is performed in Muslim and Jew communities as a religious tradition with almost two-thirds of circumcised males worldwide being Muslims.…”