Male circumcision, the removal of the foreskin from the penis, is a common surgical procedure performed globally for cultural, religious, and health considerations. For newborns and infants, the Plastibell technique is a widely used method. This technique employs a specialized device with a distinct mechanism for foreskin removal. Understanding the process, from the device’s function to post-procedure care, can help individuals feel more informed.
How the Plastibell Device Works
The Plastibell device is a small, clear plastic ring designed with a deep, circumferential groove along its outer surface. A clinician selects the appropriately sized Plastibell based on the diameter of the glans. The device acts as a protective shield for the glans, or head of the penis, throughout the procedure.
The mechanism relies on cutting off the blood supply to the tissue designated for removal. Once the device is in place, a surgical thread, called a ligature, is tied tightly around the foreskin and secured within the Plastibell’s groove. This tight constriction crushes the foreskin tissue against the plastic ring, leading to a loss of blood flow, known as strangulation. The resulting lack of circulation causes the tissue beyond the tight tie to die, eventually resulting in a clean separation.
The plastic ring remains attached to the penis, protecting the glans while the tissue slowly separates over several days. The device and the dead foreskin tissue are designed to naturally fall away together, leaving a healed, circumferential wound. This self-removal method is a defining characteristic of the Plastibell technique.
The Procedure: Application and Immediate Steps
Preparation involves cleaning the area and establishing a sterile field to prevent infection. Pain management is necessary, often involving a local anesthetic cream and a dorsal penile nerve block or ring block injection applied at the base of the penis. The clinician waits five to eight minutes to ensure the anesthetic has fully taken effect before proceeding.
The medical professional gently separates any natural adhesions between the foreskin and the glans, fully exposing the coronal groove. The pre-selected Plastibell device is then carefully inserted beneath the foreskin. The foreskin is drawn over the bell, and the ligature is securely tied around the foreskin, seating it firmly in the device’s groove.
After tightening the ligature, the clinician uses a scalpel or scissors to trim away the excess foreskin protruding beyond the plastic ring’s edge. The handle on the Plastibell is then broken off, leaving only the ring and the tight ligature in place. The entire procedure is quick, taking about 5 to 10 minutes, and the newborn is often discharged shortly after passing urine.
Post-Procedure Care and Expected Healing
Immediately following the procedure, parents are instructed on care protocols to ensure proper healing and minimize discomfort. Pain relief, such as acetaminophen, may be given regularly for the first 24 to 48 hours to manage soreness. Keeping the area clean is important, and bathing the infant is encouraged starting the day after the procedure to support healing.
Aftercare involves applying petroleum jelly to the penis and the front of the diaper at every change while the ring is in place. This prevents the plastic ring and healing tissue from sticking to the diaper, which could cause pain and disrupt healing. Swelling and bruising around the area are expected and considered normal results of the procedure.
The Plastibell ring is expected to detach spontaneously within five to ten days. During this period, the section of foreskin beyond the ligature will darken and appear black or gray as the tissue dies and prepares to separate. A yellow or white discharge on the healing wound is also normal and does not indicate an infection. If the ring has not fallen off after 14 days, medical attention is required for its removal.
Parents should contact a healthcare provider immediately if they observe signs such as excessive bleeding, an inability to urinate, a high fever, or if the ring slips down the shaft of the penis prematurely.