Meatal stenosis following circumcision with Plastibell device and conventional dissection Surgery; a prospective investigation

Introduction: Meatal stenosis is a late complication of circumcision. Objectives: This study was designed to determine its prevalence, its relationship with age of circumcision and its applied method. Material and Methods: This prospective study was conducted between December 2006 and January 2012. A total of 2389 boys, equal to or less than 6 years were circumcised using the Plastibell device (PD) or conventional dissection surgery (CDS). They followed up 12 months after surgery. Signs and symptoms of meatal stenosis recorded and the meatus evaluated for stenosis. Results: Meatal stenosis was diagnosed in 41 boys (1.7%). Twenty-five of patients were asymptomatic (61%). The difference between the mean age of circumcision in patients with meatal stenosis and the others were statistically significant. In newborns the prevalence of meatal stenosis was more than the other ages (15% versus 1.4%, P < 0.01). Concerning the method of circumcision, a significant difference on the prevalence of meatal stenosis was detected too (0.8% in PD versus 3.6% in CDS; P < 0.001). The mean interval between circumcision and diagnosis of meatal stenosis was 9.59 months. Conclusion: Symptomatic presentation of meatal stenosis may be late and it needs long-term follow-up. Its prevalence is higher in younger boys. Thus, circumcision in younger boys, especially in neonates is not recommended. Using PD has lower rate of meatal stenosis in comparison to CDS. Hence, the result of this study showed, the PD is preferable in younger boys.