title: Penile injuries from proximal migration of the Plastibell circumcision ring.
abstract: BACKGROUND
  Although circumcision is the commonest surgical procedure performed on male neonates, complications still arise from all methods used by operators.
  
  
  METHODS
  This was a prospective study of penile injuries resulting from proximal migration of the Plastibell device in neonate boys referred to the Lagos University Teaching Hospital, Lagos, Nigeria. The parameters measured were patients' biodata, presentation, management and treatment outcome.
  
  
  RESULTS
  Twenty-three injuries resulting from circumcision with the Plastibell device all occurred from prolonged retention of the ring. In each case, the ring was retained and had migrated proximally. There was extensive skin loss in 17 (74%) babies. Urethrocutaneous fistulae were the result in nine (39%) of these cases, while partial necrosis of the glans penis occurred in four (17%). These complications resulted from the use of wrong-sized Plastibell kits, lack of follow-up by the medical staff, and inadequate maternal knowledge of ring fall-out time.
  
  
  CONCLUSIONS
  Proximal migration of the Plastibell ring can result from employment of an inappropriate size, causing grievous penile injury. Adequate information should be provided to mothers of circumcised babies about possible complications of the Plastibell kit when employed. There is a need to redesign the Plastibell kit to eliminate its migration up the penile shaft.
authors: Pediatric Surgery Unit, Department of Surgery, College of Medicine University of Lagos/Lagos University Teaching Hospital, PMB Lagos, Nigeria. cobode@yahoo.com
authors: C O
authors: CO
authors: Bode
authors: S
authors: S
authors: Ikhisemojie
authors: A O
authors: AO
authors: Ademuyiwa
mesh_terms: D002944:Circumcision, Male / Q000295:instrumentation*; D005548:Foreign-Body Migration / Q000150:complications*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D010413:Penis / Q000293:injuries*; D011446:Prospective Studies