Comparison of complications of infant circumcision devices

Consideration	Mogen	Gomco	Plastibell
Bleeding	Similar risk (1.0%).	Similar risk (1.0%).	Similar risk (1.0%). Associated with injury to the frenulum during application of the bell and/or loose ligature.
Urethral injury	Reduced risk.*	Increased risk (dorsal slit routinely required).	Increased risk (dorsal slit routinely required).
Penile laceration/amputation	Increased risk (glans may not be protected).	Increased risk (related to mismatching device parts).	Reduced risk.
Urinary retention, bladder rupture, injury from retained parts	No risk (no retained parts).	No risk (no retained parts).	Increased risk if bell of wrong size is used, as it can slip back on to shaft of penis, causing gangrene, urinary retention and bladder rupture.
Buried glans	Increased risk if surgeon does not free glans.	Similar risk.	Similar risk.
Other comment	Penile amputations can occur even under ideal circumstances.	When matching non-defective parts are used there is essentially no risk of injury to the glans.	Complications from retained parts can occur even under ideal circumstances.

* Use of the Mogen clamp reduces the risk of urethral injury compared with no clamp use.

Reprinted and adapted from: Manual for early infant male circumcision under local anaesthesia, Overview of surgical devices, World Health Organization, p. 51, Copyright © 2010. Available from: https://apps.who.int/iris/handle/10665/44478 (Accessed on July 21, 2022).

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Comparison of complications of infant circumcision devices