The study of the factors affecting the time of ring fall off in circumcision using Plastibell

INTRODUCTION: Circumcision is one of the oldest surgeries and is commonly done in various communities. One of the most common methods of this operation is using a ring or plastible. Given that one of the complications of circumcision by the ring is a delay in the ring fall off, this study is done with the purpose of determining the factors that affect the time of the ring fall off. MATERIALS AND METHODS: This study was done in case series—prospective way. At first, local anesthesia was performed in the form of ring block and using 0.2 cc lidocaine 2% per kg body weight with an insulin syringe and then, by making a linear incision on the foreskin, a ring of the right size was placed on the glans. The foreskin was stretched on the ring and the 0–2 or 0–3 suture was tied to the ring groove and finally, the foreskin was removed from the distal part to the ring. Parents were asked about age, size of suture used, time of ring fall off, and status of sitz bath usage and were recorded even they done completely, incompletely, or not. RESULTS: Finally 465 patients started the study with the average age of 7.55 4 ± 4.72 months. The average time of the ring fall off was 66.7 ± 60.2 days. People who had used the sitz bath completely (92.6 ± 36.2 days), compared to those who had used incompletely (63.8 ± 06.2 days) or no use at all (93.9 ± 58.2 days), they had shorter ring retention time (P < 0.001). Also, people who were used 0–3 suture had shorter ring retention time compared to those who were used 0–2 suture (82.6 ± 42.2 days versus 56.2 ± 27.8 days and P < 0.001). There was a significant relationship between age of ring retention and age, and the time of the ring fall off is shorter in those who are younger and the “less than or equal to 3 months” age group had the least time of the ring fall off. CONCLUSION: The results of this study showed that there is a significant relationship between the duration of the ring fall off and the age of individuals and the use of a sitz bath and the use of thinner suture (0–3).