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Circumplast is the safest circumcision disposable ring for male babies and children. We are sole distributor in UK. It is better than Plastibell. Centres who are using the Circumplast device are located  at London, Cambridge, Leyton,  and Luton,

Circumplast babies circumcision.jpg

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Circumplast is ideal for baby and boys circumcions 

RE-AUDIT OF EARLY COMPLICATION ESPECIALLY IMPACTION OF DISPOSABLE DEVICE: IMPROVING OUTCOMES OF CIRCUMCISIONS WITH PLASTIBELL AND CIRCUMPLAST RINGS IN CHILDREN IN A COMMUNITY CLINIC

Javaria Akram

AIM: To evaluate the early postoperative complications particularly impaction of disposable devices ( Plastibell and Circumplast ) in children’s circumcision procedures under local anaesthesia between different age groups, size and types of rings, and different doctors in a community clinic.
MATERIAL AND METHODS
In our re-audit, the outcome of circumcisions (n=1449) was studied over a 1 year period (May 2016 to April 2017) performed under local anaesthesia, by trained doctors in a community clinic doing Circumplast Circumcisions (CC) (n=470) and Plastibell circumcisions (PC) (n=979). Data was collected prospectively and early postoperative complications especially ring impaction were compared between age of the child, size and types of device, and doctors who have performed the circumcision. Follow-up was arranged if required.
RESULTS
The mean age was 6.5±0.4 months (median 1.6). Overall complication rate was 6.7% (97/1449). There is no significant difference in overall complications rate in CC (7% n=33/470) versus PC (6.5% n=64/979) (p>0.5). Although ring impaction is significantly lower in Circumplast circumcision  (0.4% n=2/470) versus Plastibell circumcision (3.4% n=33/979) (p<0.05) but it has significantly improved from the previous audit (CC 3.2% n=7/208 versus PC 8.7% n=102/1179 – ESPU 2016). There is significantly lower incidence in ring impaction with Plastibell size 1.4 as compared to 1.3, 1.5 and 1.7. There is no impaction in 1.1 and 1.2 sizes. Ring impaction was significantly lower in infants versus over 1 year child (1.5% vs 10% n= 19/1280 vs 17/169, p<0.5) respectively. There is no significant difference in complications (8.5%, 7.1%, 6.5%, 5.8% and 5%) among the five doctors’ cases (p>0.5). Mean follow-up for 354 (24%) children were 14 days (median 6).
CONCLUSIONS
This concludes that no significant difference noted in overall early complications of circumcisions between age of the child, size and types of device used, and among different doctors. However, ring impaction was significantly lower in infants, Plastibell size 1.4 and Circumplast.

Accepted as a poster and presentation in ESPU 2018. This abstract is published at https://congress2018.espu.org/

All children operated at Thornhill clinic, Luton, Leyton Clinic, London and Croydon Clinic, London

ADEQUATE PERI-OPERATIVE MANAGEMENT DECREASES COSMETIC COMPLICATIONS AFTER CIRCUMCISION WITH DISPOSABLE RINGS (CIRCUMPLAST AND PLASTIBELL) IN CHILDREN

Javaria Akram

Source: ESPU 2017, Thornhill and London Circumcision Clinic, England UK

"We reviewed our experience in treating children with cosmetic complications following non-therapeutic male circumcision (NMC) with Plastibell and Circumplast devices at a community clinic. This study highlights the factors leading to these complications and clinical management to improve the cosmetic appearance.

A retrospective review of 3360 children who underwent Circumplast (CC) and Plastibell circumcision (PC) under local anaesthesia at a community clinic from May 2014 to October 2016. Parents were given detailed information and consented preoperatively in children with potential risks. This was provided verbally and in written format.

All complications were reviewed by a paediatric surgeon. All preputial adhesions were separated under anaesthetic cream. Buried penis was treated conservatively. Incomplete circumcisions were corrected by excision of excess skin.  Acquired phimosis was treated by steroid, simple double incision of the scar and surgical reconstruction. Complications were further looked for CC and PC. Follow-up visits were arranged in all cases.

There is no significant difference in the complications between Circumplast Circumcision  (2.2 % n=22/1002) and Plastibell circumcision  (2.3% n= 55/2357). Preputial adhesions were higher in Plastibell Circumcision  (1.5%) than Circumplast Circumcision  (0.8%) but not statistically significant. 

Children with cosmetic complications following NMC by disposable rings (Circumplast and Plastibell) can be prevented by meticulous perioperative management. Parental education and surgical expertise is required to minimise these complications"

ESPU 2017

Company has launched Circumplast device for children circumcision in USA

Javaria Akram

Circumplast is FDA approved, CE certified and TGA approved.

Circumplast has completely eliminated well known risks associated with the use of bell shaped devices such as the Plastibell. In particular, complications arising from proximal migration of the Plastibell device has been completely eliminated by the design of Circumplast.

The surgical procedure required for Circumplast is essentially identical to Plastibell.

Please see company website for further details: 

http://www.novadien.com/for-doctors/

Circumcisions with Circumplast has reached to 1000 in number at Thornhill and London (Leyton and Croydon) clinic in October 2016

Javaria Akram

Circumcisions with Circumplast has reached to 1000 in number at Thornhill and London (Leyton, Oliver Road, and Croydon) clinic in October 2016.

Non-therapeutic male circumcision by the Circumplast device can be safely performed in a community clinic. This novel device decreases the risks of complication especially in children under 3 months of age.

Use of Circumplast in case of mild buried penis

Javaria Akram

Circumplast is best use in mild to moderate  buried penis and short foreskin. This is because that The Circumplast circumcision device provides several locations at which the ligature can be secured. This can be used to choose the amount of foreskin to be removed.  The ribs provide further locations for the ligature to be secured and also ensure that the ligature cannot migrate by acting as static barriers. An important feature of the Circumplast circumcision device is the fact that the device is inserted up to the coronal sulcus. This ensures that the ligature can be secured at any location along the body of the Circumplast without inducing any tension in the foreskin.

Outcome of Circumplast and Plastibell at Thornhill Circumcision Centre

Javaria Akram

This cohort study will evaluate the early postoperative complications in Circumplast and Plastibell techniques, in a community clinic- Thornhill Circumcision Centre, for non-therapeutic male circumcision.

We reviewed the outcome of non-therapeutic male circumcision in children (n=1387) over a 1 year period (May 2014 to April 2015) in a community clinic - Thornhill clinic , performed under local anaesthesia, by trained doctors with the backup of a trained paediatric surgeon (figure 1-4). The technique was selected by doctors’ preference. Data was collected prospectively and early postoperative complications were compared between Circumplast and Plastibell circumcisions. Follow-up consultations were arranged if required.

The mean age was 18 ± 1.9 months (median 5.1) in Circumplast circumcision (CC) and 9.4 ± 0.6 months (median 1.5) in Plastibell circumcision (PC). Incidence of complications is significantly lower in CC (6.3% n=13/208) versus PC (13% n=154/1179) (p<0.05) (complications graph). Postoperative use of antibiotics was higher in CC versus PC (6.7% vs 3.8% n=14 vs 45) but not statistically significant (P>0.05). Mean follow-up consultations were 19 days (range 1 to 373) in CC and 20 days (range 1 to 305) in PC.

Outcome

Non-therapeutic male circumcision by the Circumplast device has a significantly lower risk of early postoperative complications in a community clinic, especially migration/impaction of the ring when compared to the standard Plastibell device.

Doctor is using Circumplast device in France

Javaria Akram

The surgeon  from Marseille, Provence-Alpes-Côte d'Azur, France has been  using the Circumplast for children's circumcision. He has been using plastibell for many years. Now he is impressed with Circumplast design and used the Circumplast in many children's circumcisions. 

NON-THERAPEUTIC MALE CIRCUMCISION IN CHILDREN WITH A NOVEL DISPOSABLE RING - CIRCUMPLAST IMPROVES THE OUTCOME AS COMPARED TO THE STANDARD PLASTIBELL DEVICE AT A COMMUNITY CLINIC

Javaria Akram

Audit is accepted at 27th European Society of Paediatric Urology Congress - Harrogate, Yorkshire England, UK - 2016

PURPOSE

This cohort study will evaluate the early postoperative complications in Circumplast® and Plastibell® techniques, in a community clinic, for non-therapeutic male circumcision.

MATERIAL AND METHODS

We reviewed the outcome of non-therapeutic male circumcision in children (n=1387) over a 1 year period (May 2014 to April 2015) in a community clinic, performed under local anaesthesia, by trained doctors with the backup of a trained paediatric surgeon. The technique was selected by doctors’ preference. Data was collected prospectively and early postoperative complications were compared between Circumplast® and Plastibell® circumcisions. Follow-up consultations were arranged if required.

RESULTS

The mean age was 18 ± 1.9 months (median 5.1) in Circumplast® circumcision (CC) and 9.4 ± 0.6 months (median 1.5) in Plastibell® circumcision (PC). Incidence of complications is significantly lower in CC (6.3% n=13/208) versus PC (13% n=154/1179) (p<0.05). Delayed ring separation/migration is significantly lower in CC (3.2% n=7/208) versus PC (8.7% n=102/1179) (p<0.05). Post-operative bleeding (0.5% vs 0.6% n= 1 vs 7), preputial adhesions (1.4% vs 2.4% n= 3 vs 28), and miscellaneous complications (0.5% vs 1% n= 1 vs 13) were lower but not statistically significant (p>0.5) in CC versus PC respectively. Postoperative use of antibiotics was higher in CC versus PC (6.7% vs 3.8% n=14 vs 45) but not statistically significant (P>0.05). In children under 6 months, the overall outcome in both groups is significantly better in comparison to 6 - 110 months old (p<0.05). Mean follow-up consultations were 19 days (range 1 to 373) in CC and 20 days (range 1 to 305) in PC.

CONCLUSIONS

Non-therapeutic male circumcision by the Circumplast® device has a significantly lower risk of early postoperative complications in a community clinic, especially migration/impaction of the ring when compared to the standard Plastibell®device.

Trends in penile cancer: a comparative study between Australia, England and Wales, and the US

Javaria Akram

Circumcision rates have a potential influence on these rates but are not the sole explanation for the variation

PURPOSE:

To investigate and compare the trends in incidence and mortality of penile cancer between Australia, England and Wales, and the US, and provide hypotheses for these trends.

METHODS:

Cancer registry data from 1982 to 2005 inclusive were obtained from Australia, England and Wales, and the United States. From these data, age-specific, -standardised and mortality:incidence ratios were calculated, and compared.

RESULTS:

The overall incidence of penile cancer in England and Wales (1.44 per 100,000 man-years) was higher than in Australia (0.80 per 100,000), and the US (0.66 per 100,000). Incidence of penile cancer in all three countries has remained relatively stable over time. Similarly, although the mortality rates were also higher in England and Wales (0.37 per 100,000 man-years) compared to Australia (0.18 per 100,000) and the US (0.15 per 100,000), the mortality/incidence ratios were similar for all three countries.

CONCLUSIONS:

Penile cancer incidence is low, affecting mainly older men. Rates differ between the three countries, being twice as common in England and Wales as in the other studied regions. Circumcision rates have a potential influence on these rates but are not the sole explanation for the variation

SOURCE:

Springerplus. 2015 Aug 14;4:420.

DOI: 10.1186/s40064-015-1191-4

 

 

A 'snip' in time: what is the best age to circumcise?

Javaria Akram

Background

Circumcision is a common procedure, but regional and societal attitudes differ on whether there is a need for a male to be circumcised and, if so, at what age. This is an important issue for many parents, but also pediatricians, other doctors, policy makers, public health authorities, medical bodies, and males themselves.

Discussion

We show here that infancy is an optimal time for clinical circumcision because an infant's low mobility facilitates the use of local anesthesia, sutures are not required, healing is quick, cosmetic outcome is usually excellent, costs are minimal, and complications are uncommon. The benefits of infant circumcision include prevention of urinary tract infections (a cause of renal scarring), reduction in risk of inflammatory foreskin conditions such as balanoposthitis, foreskin injuries, phimosis and paraphimosis. When the boy later becomes sexually active he has substantial protection against risk of HIV and other viral sexually transmitted infections such as genital herpes and oncogenic human papillomavirus, as well as penile cancer. The risk of cervical cancer in his female partner(s) is also reduced. Circumcision in adolescence or adulthood may evoke a fear of pain, penile damage or reduced sexual pleasure, even though unfounded. Time off work or school will be needed, cost is much greater, as are risks of complications, healing is slower, and stitches or tissue glue must be used.

Summary

Infant circumcision is safe, simple, convenient and cost-effective. The available evidence strongly supports infancy as the optimal time for circumcision.

source 

BMC Pediatr. 2012; 12: 20.

DOI:  10.1186/1471-2431-12-20

Experience of 112 cases of Circumplast circumcsion presented in the 26th Congress of the European Society for Paediatric Urology, Prague 14-17 October 2015

Javaria Akram

Our expert surgeon presented Circumplast experience of 112 cases to the 26th Congress of the European Society for Paediatric Urology. This was a joint meeting with Society for Paediatric Urology, American Association of Pediatric Urologists, American Academy of Pediatrics/Section on Urology, Society for Fetal Urology and International Children’s Continence Society. This was one of the largest gatherings of paediatric urologists from across all continents providing an exciting experience at Prague, Czech Repulic on 14-17 October 2015.