Home Print this page Email this page Small font sizeDefault font sizeIncrease font size
Users Online: 106
 
About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Subscribe Contacts Advertise Login 
     


 
 Table of Contents  
EBN SYNOPSIS
Year : 2013  |  Volume : 2  |  Issue : 3  |  Page : 113-114

Petroleum jelly for prevention of post-circumcision meatal stenosis


Consultant Neonatologist, Neonatal Division, King Abdulaziz Hospital, Al-Ahsa, Saudi Arabia

Date of Web Publication18-Oct-2013

Correspondence Address:
Sameer Y Al-Abdi
Consultant Neonatologist, Neonatal Division, King Abdulaziz Hospital, Al-Ahsa
Saudi Arabia
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2249-4847.119988

Rights and Permissions

How to cite this article:
Al-Abdi SY. Petroleum jelly for prevention of post-circumcision meatal stenosis. J Clin Neonatol 2013;2:113-4

How to cite this URL:
Al-Abdi SY. Petroleum jelly for prevention of post-circumcision meatal stenosis. J Clin Neonatol [serial online] 2013 [cited 2020 Jul 13];2:113-4. Available from: http://www.jcnonweb.com/text.asp?2013/2/3/113/119988


  Context Top


Post-circumcision meatal stenosis (PCMS) is well-recognized late complication of circumcision performed during diaper age. [1] Accordingly, rubbing between circumcised site and the diaper is one of plausible causes of PCMS. Most of PCMS are corrected surgically (meatotomy) under general anesthesia. [2] Bazmamoun, et al., aimed to evaluate the hypothesis that lubricating the circumcision site would reduce the incidence of PCMS.


  Materials and Methods Top


A single-center randomized controlled trial (RCT) on boys younger than 2-years-old referred to an Iranian hospital for circumcision between 2006 and 2007. The boys were randomized into two groups: The intervention group in which parents applied petroleum jelly on glans and meatal area after each diaper change for 6 months post-circumcision and the control group in which parents were instructed not to apply any lubricant on circumcised sites. All circumcisions were performed by the same surgeon according to the sleeve method. Gentamicin-soaked gauze was applied on circumcision site in both groups. Boys in both groups were evaluated for 6 months: Every alternate day for the first 2 weeks; then weekly for 1 month, and then bi-weekly.

Population

A sample size calculation revealed that 200 boys would be required for each group. Four hundred boys younger than 2-years-old enrolled, but six (three in each group) were excluded from the analysis because of poor follow-up compliance.

Inclusion

Boys younger than 2-years-old.

Exclusion

None.

Intervention

Petroleum jelly on glans and meatal area after each diaper change for 6 months.

Outcomes

Primary


PCMS.

Secondary

  • Infection of the circumcision site.
  • Post-circumcision bleeding.
  • Time of recovery.


Allocation concealment

Not reported.

Blinding

Not feasible.


  Results Top


Results are shown as follows in [Table 1].
Table 1: Results of main outcomes

Click here to view



  Commentary Top


This RCT scored 5 out of 5 on the Jadad scale as the double blinding was not feasible. [3] It showed that the petroleum jelly was effective for preventing the PCMS with a number to treat of 15 (95% confidence interval: 9, 30). The petroleum jelly reduced risk of post-circumcision infection and bleeding. The petroleum jelly nearly halved the recovery time of the circumcision sites. However, a robust definition of post-circumcision infection, bleeding, and recovery time was not provided. It seems that age of the study boys and recovery time of circumcision site were not normally distributed or there were outliers as 2 standard deviation (SD) below the means would yield unrealistic data. Accordingly, it would have been more appropriate to represent these two variables as the median with range or interquartile range instead of the mean (SD). A nonparametric test would be more appropriate for these two variables than the parametric t-test. Moreover, several online two sample t-test calculators yielded a P < 0.0001 for the difference between means of recovery time, which is much smaller than the reported P value (0.03). In summary, this RCT demonstrated that an easy, safe, cheap, widely available intervention (petroleum jelly) reduces some of early and late complications of circumcision. It is prudent to apply the petroleum jelly on glans and meatal area of circumcised boys after each diaper change for 6 months post-circumcision.

Abstracted from

Bazmamoun H, Ghorbanpour M, Mousavi-Bahar SH. Lubrication of circumcision site for prevention of meatal stenosis in children younger than 2 years old. Urology journal. 2008;5 (4):233-6. Epub 2008/12/23.

 
  References Top

1.Weiss HA, Larke N, Halperin D, Schenker I. Complications of circumcision in male neonates, infants and children: A systematic review. BMC Urol 2010;10:2.  Back to cited text no. 1
    
2.Van Howe RS. Incidence of meatal stenosis following neonatal circumcision in a primary care setting. Clin Pediatr (Phila) 2006;45:49-54.  Back to cited text no. 2
    
3.Jadad AR, Enkin MW. Randomized controlled trials: Questions, answers and musings. 2 nd ed. Malden, Massachusetts: USA: Blackwell Publishing, Inc.; 2007.  Back to cited text no. 3
    



 
 
    Tables

  [Table 1]



 

Top
 
 
  Search
 
Similar in PUBMED
  Search Pubmed for
  Search in Google Scholar for
Access Statistics
Email Alert *
Add to My List *
* Registration required (free)

 
  In this article
Context
Materials and Me...
Results
Commentary
References
Article Tables

 Article Access Statistics
    Viewed1865    
    Printed46    
    Emailed0    
    PDF Downloaded258    
    Comments [Add]1    

Recommend this journal