By Danelle Day © 2010
The Plastibell comes in six sizes to fit over the glans of various baby boys' penises at birth.
The most common size used is 1.3cm in diameter, followed by 1.2cm. Larger sizes of 1.5 and 1.7cm are used infrequently.
Plastibell circumcision is often touted as a 'new method' or said to be one that is 'less invasive' or even 'non-cutting.' Each of these fallacies in North American culture today are without merit, but parents continue to buy into the myths of the Plastibell, and too often find their sons subject to the perils that come with genital cutting.
The fact of the matter is that all forms of circumcision involve cutting and blood. To 'circumcise' comes from the Latin, circumcidere, and literally means 'to cut around.' The Plastibell was invented in 1950 by Hollister Incorporated - it is not new, but has become more widely used today thanks to special marketing strategies. Currently, the Plastibell and Gomco are the two most common forms of infant circumcision in the United States. With Plastibell circumcision, the prepuce (foreskin) is torn apart from the glans (head) of the penis with a sharp probe, where it is tightly adhered at birth as your fingernails are to your fingers. The prepuce is then clamped away from the glans, while a plastic bell is placed over the glans and a string tied tightly around the prepuce. The majority of the prepuce is then cut away with a scalpel or surgical scissors, (bleeders clamped and sutures sewn if needed), leaving only the base of the prepuce remaining on the bell when baby is returned to his parents. Because this is all that most parents see, many are left believing that the plastic bell is all that was ever done to their son. This is far from the reality of the surgery - one commonly performed without anesthesia. Within the video here and at the Plastibell Resource Page, we are able to view Plastibell circumcision first hand.
Just as all forms of circumcision involve genital cutting and blood, each method also poses risk to the individual whose body is cut. The most common complications with Plastibell occur when the foreskin slips and retracts during the surgery. Other common concerns are excessive bleeding and an increased risk of post-op infection. With Plastibell circumcision, the prepuce is amputated with a scalpel, just as with Gomco style circumcision (the other most common form of genital cutting in North America). However, there are no clamps other than forceps held by the individual doing the cutting which keep the prepuce torn away from the glans as it is being cut and the plastic bell and string placed. Because of this, Plastibell circumcision is more complicated, has been shown to take twice as long as other methods [1], foreskin slippage is common, and the numbers of 'botched' circumcision reports and parents seeking repeat circumcision surgery has skyrocketed.
In an article [2] published in Nature Clinical Pediatric Urology, Dr. Robert Van Howe addresses additional concerns with Plastibell circumcision (as well as other forms of infant genital cutting). He writes:
References
1. Taeusch, H.W. et al. (2002). "Pain During Mogen or PlastiBell Circumcision." Journal of Perinatology, 22; 3: 214-218.
2. Van Howe, R.S. (2009). "Is Neonatal Circumcision Clinically Beneficial? Argument Against." Nature Clinical Practice Urology, 6; 2: 74-75.
3. Sorrells, M.L. et al. (2007). "Fine-touch pressure thresholds in the adult penis." British Journal of Urology International, 99: 864–869
4. Yang, D.M. et al. (2008). "Circumcision affects glans penis vibration perception threshold." [Chinese]. Zhonghua Nan Ke Xue, 14: 328–330
5. Fink, K.S. et al. (2002). "Adult circumcision outcomes study: effect on erectile function, penile sensitivity, sexual activity and satisfaction." Journal of Urology, 167: 2113–2116
6. Nguyen, D.M. et al. (2007) Risk factors for neonatal methicillin-resistant Staphylococcus aureus infection in a well-infant nursery. Infection Control and Hospital Epidemiology, 28: 406–411
The most common size used is 1.3cm in diameter, followed by 1.2cm. Larger sizes of 1.5 and 1.7cm are used infrequently.
Plastibell circumcision is often touted as a 'new method' or said to be one that is 'less invasive' or even 'non-cutting.' Each of these fallacies in North American culture today are without merit, but parents continue to buy into the myths of the Plastibell, and too often find their sons subject to the perils that come with genital cutting.
The fact of the matter is that all forms of circumcision involve cutting and blood. To 'circumcise' comes from the Latin, circumcidere, and literally means 'to cut around.' The Plastibell was invented in 1950 by Hollister Incorporated - it is not new, but has become more widely used today thanks to special marketing strategies. Currently, the Plastibell and Gomco are the two most common forms of infant circumcision in the United States. With Plastibell circumcision, the prepuce (foreskin) is torn apart from the glans (head) of the penis with a sharp probe, where it is tightly adhered at birth as your fingernails are to your fingers. The prepuce is then clamped away from the glans, while a plastic bell is placed over the glans and a string tied tightly around the prepuce. The majority of the prepuce is then cut away with a scalpel or surgical scissors, (bleeders clamped and sutures sewn if needed), leaving only the base of the prepuce remaining on the bell when baby is returned to his parents. Because this is all that most parents see, many are left believing that the plastic bell is all that was ever done to their son. This is far from the reality of the surgery - one commonly performed without anesthesia. Within the video here and at the Plastibell Resource Page, we are able to view Plastibell circumcision first hand.
Just as all forms of circumcision involve genital cutting and blood, each method also poses risk to the individual whose body is cut. The most common complications with Plastibell occur when the foreskin slips and retracts during the surgery. Other common concerns are excessive bleeding and an increased risk of post-op infection. With Plastibell circumcision, the prepuce is amputated with a scalpel, just as with Gomco style circumcision (the other most common form of genital cutting in North America). However, there are no clamps other than forceps held by the individual doing the cutting which keep the prepuce torn away from the glans as it is being cut and the plastic bell and string placed. Because of this, Plastibell circumcision is more complicated, has been shown to take twice as long as other methods [1], foreskin slippage is common, and the numbers of 'botched' circumcision reports and parents seeking repeat circumcision surgery has skyrocketed.
In an article [2] published in Nature Clinical Pediatric Urology, Dr. Robert Van Howe addresses additional concerns with Plastibell circumcision (as well as other forms of infant genital cutting). He writes:
Circumcision removes a complex, pentilaminar, specialized, junctional structure that contains nearly all the penis' fine-touch neuroreceptors. Not surprisingly, the foreskin is the most sensitive portion of the penis. Circumcision can reduce the sensitivity of the glans to fine-touch and vibration.[3,4] No wonder adults who undergo circumcision report less-satisfying sex, reduced sensitivity and erectile function, difficulty with intromission, and increased premature ejaculation.[5] Other commonly reported complications of circumcision include infection (1–3%), excessive bleeding (1–9%), meatitis (20%), meatal stenosis (5–8%), subcutaneous granuloma (5%), balanitis (16%), coronal adhesions (30%), skin bridges (2%), and phimosis (1–2%). Parents also request a repeat circumcision for cosmetic reasons in 2% of cases. Furthermore, circumcised newborn boys are 12 times more likely to acquire community-associated methicillin-resistant Staphylococcus aureus infections than uncircumcised newborns.[6] Other less-common complications of circumcision include septicemia, meningitis, Fournier gangrene, staphylococcal scalded skin syndrome, osteomyelitis, septic arthritis, tetanus, herpes simplex infection, empyema, pubic hair strangulation, denudation of the penis, glans amputation, urethral fistula, penile edema, pyogenic granulomas, acute urinary retention with acute renal failure, ruptured bladder, UTI or urine advancing in subcutaneous fascial plains, penile ischemia, pneumothorax, pseudoparaphimosis, pulmonary embolism, unilateral leg cyanosis, gastric rupture, myocardial injury and erythema multiforme.What follows below are graphic examples of complications due to circumcision by Plastibell. It is a form of genital cutting that is certainly not without risk and one whose side effects are commonplace in today's medical literature. To learn more about Plastibell circumcision, see this resource page and associated citations.
References
1. Taeusch, H.W. et al. (2002). "Pain During Mogen or PlastiBell Circumcision." Journal of Perinatology, 22; 3: 214-218.
2. Van Howe, R.S. (2009). "Is Neonatal Circumcision Clinically Beneficial? Argument Against." Nature Clinical Practice Urology, 6; 2: 74-75.
3. Sorrells, M.L. et al. (2007). "Fine-touch pressure thresholds in the adult penis." British Journal of Urology International, 99: 864–869
4. Yang, D.M. et al. (2008). "Circumcision affects glans penis vibration perception threshold." [Chinese]. Zhonghua Nan Ke Xue, 14: 328–330
5. Fink, K.S. et al. (2002). "Adult circumcision outcomes study: effect on erectile function, penile sensitivity, sexual activity and satisfaction." Journal of Urology, 167: 2113–2116
6. Nguyen, D.M. et al. (2007) Risk factors for neonatal methicillin-resistant Staphylococcus aureus infection in a well-infant nursery. Infection Control and Hospital Epidemiology, 28: 406–411
NOTE:
** GRAPHIC **
For Educational Purposes.
** GRAPHIC **
For Educational Purposes.
NOT SUITABLE FOR SOME WORK LOCATIONS OR CHILDREN
When applicable, clinical citations and study links provided with images.
"Penile injuries from proximal migration of the Plastibell circumcision ring." Journal of Pediatric Urology, Volume 6, Issue 1, February 2010, Pages 23–27. Plastibell has migrated up the shaft of the penis eight days post circumcision:
Glans experiences cellular death 13 days post Plastibell circumcision:
"Penile injuries from proximal migration of the Plastibell circumcision ring." Journal of Pediatric Urology, 6; 1:23-7. Prolonged retention, penile skin loss, urethrocutaneous fistulae (urethral damage) and partial glans death among 23 newborn baby boys.
Meatal ulceration post Plastibell - urine burns on an open surgical wound. Details.
"Surgical Repair of Traumatic Amputation of the Glans." Urology
Volume, Vol 77, Issue 6, June 2011, Pages 1472–1473. Glans trauma post Plastibell resulting in complete amputation of penile glans:
"Urethral transection following neonatal circumcision using a Plastibell device." Images in Clinical Practice, 2012, Vol 17, Issue 2, Page 87. Urethral damage post Plastibell:
Separation, bleeding, tissue death and strangulation due to improperly sized Plastibell:
Conference case report: Infection after Plastibell circumcision: Department of Surgery at the Children’s Hospital and Medical Center, University of Washington, Seattle, Washington. February 15, 1996. Details. Necrotizing Fasciitis two days post Plastibell:
Glans tissue death post Plastibell:
Retained Plastibell, migration, penile skin loss:
Retained Plastibell and Strangulation - University of Florida Pediatrics:
Infection, strangulation, amputation:
"Necrotizing fasciitis after neonatal circumcision." American Journal of Diseases of Children, Volume 134, Number 3: Pages 301-302. Swelling, pus and blood in diapers followed by Necrotizing Fasciitis two days post Plastibell:
"Necrotizing fasciitis after Plastibell circumcision." Journal of Pediatrics, Volume 31, Pages 459-462. Tenderness, pain, swelling and Necrotizing Fasciitis two days post Plastibell:
Two days post Plastibell hemorrhaging and Necrotizing Fasciitis:
If you know of a case that should be added to this list write to DrMomma.org@gmail.com
How Plastibell circumcision happens.
