Retrospective study of plastic ring circumcision outcomes in Ibra Hospital, Sultanate of Oman: a study of 4251 cases

Background: This study aimed to evaluate the outcomes of circumcision performed using the plastic ring technique in infants aged between 1 month and 12 months old. Methods: The cases included in this study were operated in the surgical outpatient clinic of Ibra hospital in Oman using plastic ring between June 2018 and June 2023. Infants aged one-month-old to twelve-months-old were included in the study. Cases done under general anesthesia were excluded from the study, as well as infants with bleeding disorders. Circumcision was carried out for religious reasons in all cases. Post-operative complications were collected and studied. Results: Patients fulfilling the inclusion and exclusion criteria were 4251 cases. The average age of the infants was 3.4±2.1 months. The mean period from surgery to ring separation was 7.6±3.14 days. Total complications were 214 cases (5.03%). Primary bleeding was noted in 17 cases (0.4%). Proximal ring migration happened in 75 cases (1.76%). Delayed ring separation was reported in 11 cases (0.26%). Excess mucosa that required redo circumcision was noted in 14 cases (0.33%). Conclusions: Plastic ring circumcision performed in infants below 1 year of age is considered a safe approach and is linked to a reduced number of complications. The rate of complications is proportionally related to increasing age at time of circumcision. The rate of complications is inversely related to the experience of the surgeon performing the technique.