Assessment of meatal stenosis in neonates undergoing circumcision using Plastibell Device with two different techniques

Abstract

Hormoz Karami, Mehdi Abedinzadeh, Mohammad Kazem Moslemi Department of Urology, Shahid Rahnemoon Hospital, School of Medicine, Yazd University of Medical Sciences, Yazd, Iran Purpose: It was intended to compare meatal stenosis (MS) as a late complication of neonatal circumcision by using two different methods of Plastibell Device circumcision. Materials and methods: A total of 2,307 healthy term newborns (6–36 hours) who were born between 2007 and 2009 in Niknafs Medical Center of Rafsanjan, Iran, were simply randomized into two groups in a controlled, nonblinded clinical trial. In group A (1,102 neonates), the frenulum was maintained intact without any manipulation, and in group B (1,205 neonates) frenular hemostasis was performed in all cases by thermal cautery. MS was assessed by follow-up visits that were made for all cases at the 24–72 hours, 60th day, 12th month, and 16th month after circumcision. Results: At 2 months follow-up visit, the rate of MS in group A was 4.9% (54) and in group B was 5.9% (71), which was not statistically significant. After 12 months, MS in group A was 8.5% (94) and in group B was 13.7% (165), which was statistically significant (P<0.001). At 16 months after circumcision, in the frenulum intact group, MS was 13.8% (152) and in the cautery group, it was 18.9% (228), which was compatible with significant difference (P=0.001). Conclusion: Our experience with large group of cases revealed that neonatal circumcision by using Plastibell Device with intact frenulum technique decreases the rate of delayed MS. Keywords: neonatal circumcision, Plastibell device, meatal stenosis

Keywords

• Neonatal circumcision
• plastibell device
• Meatal stenosis.