title: Acquired phimosis after plastibell circumcision: a preventable consequence.
abstract: BACKGROUND
  The plastibell device is used successfully for religious and cultural circumcisions in the community. The aim of this article is to highlight the recognition and management of iatrogenic phimosis.
  
  
  METHODS
  A retrospective study was performed of outcomes of plastibell  circumcision in a community-based circumcision service provided by trained paediatric surgeons. The objective was to assess the complication of slipped plastibell rings and to ascertain the effectiveness of its management.
  
  
  RESULTS
  A total of 5 patients with a slipped plastibell ring were  indentified out of 560 plastibell circumcisions. Three patients presented with acquired phimosis. In two patients early diagnosis and management prevented any further complications and a second operation was avoided.
  
  
  CONCLUSIONS
  Plastibell circumcision in the community is safe and effective.  Detection of minor bleeding due to a slipped ring is important. Early management can avoid the risk of acquired phimosis due to cicatrix formation and can save parents of undue anxiety.
authors.affiliation: Leeds Teaching Hospitals NHS Trust, UK.
authors.forename: E A
authors.initials: EA
authors.lastname: Kidger
authors.forename: N
authors.initials: N
authors.lastname: Haider
authors.forename: A
authors.initials: A
authors.lastname: Qazi
mesh_terms: D002944:Circumcision, Male / Q000009:adverse effects* / Q000295:instrumentation; D042241:Early Diagnosis; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D008297:Male; D010688:Phimosis / Q000209:etiology* / Q000517:prevention & control; D012189:Retrospective Studies