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The [[foreskin]] must first be slit and forced from the [[glans]] to allow entry for the plastic dome.
Furthermore, because convalescence depends on a (temporarily) affixed medical device, risks of infection or hemorrhage due to the bell slipping or otherwise failing are greater<ref>{{REFnews | last=Brennae | first=Mark | coauthors= | url=http://www.canada.com/vancouversun/story.html?id=cb3b8281-4134-46ba-85d3-b076072bda75&k=25810 | title=Ontario boy dies after complications from circumcision | date=June 13, 2007 | publisher=The Vancouver Sun: CanWest News Service | quote= | accessdate=2008-07-16}}</ref> than a [[Gomco| Gomco clamp]] or similar entirely-supervised circumcision.
There are several reports in the literature of urinary retention after circumcision with the Plastibell device.<ref>{{REFjournal