Comparative Study for the Safety of Circumcision by Classical Method and by Plastibell in Children

Abstract

Background: Circumcision is one of the most commonly performed surgical procedures in children. Classical (dissection) circumcision and the Plastibell device are among the most widely used techniques, but there is limited consensus on which offers the better safety profile across different paediatric age groups.
Aim: To compare the safety of circumcision by the classical (dissection) method and by the Plastibell device in children, and to assess whether complication rates vary with age.
Materials and Methods: This prospective comparative study was conducted in the Department of General Surgery, Victoria Hospital, Bengaluru, over a 3-month period (March–May 2026). A total of 100 boys ≤5 years presenting for circumcision were included, 50 undergoing the classical technique and 50 undergoing Plastibell circumcision. Patients were followed up postoperatively, and complications — bleeding, surgical site infection, adhesion, and delayed ring separation (Plastibell only) — were recorded and compared between groups and across age categories.
Results: The overall complication rate was significantly lower with the classical technique than with Plastibell (10% versus 28%, p=0.008). Individual complication types — bleeding, surgical site infection, and adhesion — did not differ significantly between groups. Complication rates increased with age in both groups, most markedly with Plastibell (7.7% in neonates to 50.0% at 5 years), although the age-stratified differences between techniques did not reach statistical significance at any individual age category (all p>0.05).
Conclusion: Plastibell circumcision is safe and broadly comparable to the classical technique in children when complications are examined within specific age categories, though its overall complication rate is higher. Complication rates rise with increasing age up to 5 years, and this trend is more pronounced with Plastibell, supporting closer postoperative follow-up in older children undergoing this technique.