A 7-year-old obese boy presented for circumcision. He underwent the procedure using a modified Plastibell technique called the "Magic Ring." Lidocaine was used for local anesthesia and the boy experienced minimal pain. The ring detached after 5 days without complications. The modified technique aims to reduce risks associated with standard Plastibell circumcision, such as bleeding and infection.

1. RESEARCH POSTER PRESENTATION DESIGN © 2019
www.PosterPresentations.com
Circumcision is a method for foreskin
tissue removal to uncover the penis
glans. Each technique has its risks and
benefits.
Introduction
A 7 year old boy came to the clinic to be circumcised. No fever, urgency and secret in urine
being found. No history of food and drug allergy found. No previous medical history
found. Patient’s body weight was 40 kg and 115 cm long. His BMI 30,2 (Obesel). All vital
signs were stable. Physical examination found the penis buried within visceral fat, no
phimosis, hipospadia, and other abnormalities. All laboratory findings within the normal
range.
The patient injected with 0,5ml Lidocaine solution by dorsal penile nerve block method
using free needle injection tool. The patient circumcised with the Magic Ring (modified
plastibell method).
The patient was treated with Mefenamic Acid 3x250mg until the bell dropped off. The
pain was barely felt by the patient. No urethral injury and urinary retention observed. The
retained part showed no sign of complication. The bell dropped off in 5 days.
Case Presentation
The Plastibell does not need routine wound closure and has a lesser risk of penile
laceration. Some modifications were made such as deeper canal to ensure faster drop-off
interval, ligation by surgical thread around the canal to reduce bleeding risk and secondary
infection, and upsizing the device 2-4mm above the glan’s diameter to prevent slippage
and migration.
Discussion
Conclusion
So this modified Plastibell might come as
a solution to reduce risks associated with
standard Plastibell usage in circumcision
patients.
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Acknowledgement / Contact
• Lutfi Aulia Rahman, MD (+6285645892496)
• Riza Mazidu, MD (+6285655402544)
Lutfi A Rahman (1), Riza Mazidu (2)
(!) dr. Harjono Hospital, Ponorogo, Indonesia;
Circumcision with Magic Ring (Modified Plastibell) for 7 y.o Boy with Obesity : A Case Report