We present the case of an infant who suffered intraperitoneal bladder perforation secondary to routine neonatal circumcision with the Plastibell device. On day-of-life 5, the patient presented with abdominal distention, vomiting, diarrhea, and severe acute renal failure. After removal of a distal meatal obstruction caused by the Plastibell device and open repair of the bladder defect, the patient had an uneventful recovery with rapid return of renal function. Despite the relative safety of the Plastibell, this case underscores the importance of careful device placement, parental education, keen clinical judgment, and prompt intervention when indicated.
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Surgical repair of extensive penile shaft skin injuries following neonatal circumcision.
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Department of Urology, Atrium Health Wake Forest Baptist, 1 Medical Center Blvd, Winston Salem, NC, 27157, United States.
Circumcision is a common procedure performed since ancient times with an excellent safety profile and potential health benefits. In the United States, it is commonly performed in the neonatal period using devices such as the Gomco, Mogen, or Plastibell device. In the rare circumstance of a complication, it is often related to bleeding and usually managed conservatively.
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Jeffs Division of Pediatric Urology, Brady Urological Institute, Department of Urology, Johns Hopkins School of Medicine, Baltimore, MD, USA.
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