Aim： To study the clinical effects of a disposable circumcision device in treatment of male patients of different ages with either phimosis or excess foreskin. Methods： One thousand two hundred patients between the ...Aim： To study the clinical effects of a disposable circumcision device in treatment of male patients of different ages with either phimosis or excess foreskin. Methods： One thousand two hundred patients between the age of 5 and 95 years underwent circumcision using this procedure in the 2-year period between October 2005 and September 2007. Of these cases, 904 had excess foreskin and 296 were cases of phimosis. Results： In 96.33% of the cases the incision healed, leaving a minimal amount of the inner foreskin with no scarring and producing good cosmetic results. There were no incidents of device dislocation or damage to the frenulum. The average operative time was 2.5 min for excess foreskin, and 3.5 min for phimosis. During the 7 days of wearing the device, mild to moderate edema occurred in 10.08 % of cases with excess foreskin and in 2.58 % of those with phimosis. Edema in the frenulum was seen in 1.67% of patients, and only 0.67% had an infection of the incision. A total of 86.25% of patients reported pain due to penile erection. After removal of the device, 0.58% of the cases had minimal bleeding around the incision, and 2.42% had wound dehiscence. Conclusion： The new device can be applied to an overwhelming majority of patients with phimosis and excess foreskin. This technique is relatively simple to perform, and patients who underwent this surgery had very few complications. Antibiotics were not required and patients reported less pain than those who were circumcised using conventional methods. Circumcision with this device requires minimal tissue manipulation, and is quicker and safer than circumcision using conventional techniques.展开更多
This systematic review assessed the safety and efficacy of the disposable circumcision suture device （DCSD） and conventional circumcision （CC） in the treatment of redundant prepuce and phimosis. Two independent re...This systematic review assessed the safety and efficacy of the disposable circumcision suture device （DCSD） and conventional circumcision （CC） in the treatment of redundant prepuce and phimosis. Two independent reviewers conducted a literature search for randomized controlled trials （RCTs） using the DCSD and CC for the treatment of redundant prepuce or phimosis in China and abroad. Nine RCTs （1898 cases） were included. Compared with the CC group, the DCSD group had a shorter operative time （standardized mean difference [SMD] = -21.44; 95% confidence intervals [95% CIs] [-25.08, -17.79]; P 〈 0.00001）, shorter wound healing time （SMD = -3.66; 95% CI [-5.46, -1.85]; P 〈 0.0001）, less intraoperative blood loss （SMD = -9.64; 95% CI [-11.37, -7.90]; P 〈 0.00001）, better cosmetic penile appearance （odds ratio [OR] =8.77; 95% CI [5.90, 13.02]; P 〈 0.00001）, lower intraoperative pain score, lower 24-h postoperative pain score, lower incidence of infection, less incision edema, and fewer adverse events. There were no differences between the CC and DCSD groups in the incidences of dehiscence, or hematoma. The results of this meta-analysis indicate that the DCSD appears to be safer and more effective than CC. However, additional high-quality RCTs with larger study populations are needed.展开更多
基金Acknowledgment The project （The Fundamental Researches of the Reproductive Health） was supported by the National Natural Science Foundation of China （G1999055905, branch topic）.
文摘Aim： To study the clinical effects of a disposable circumcision device in treatment of male patients of different ages with either phimosis or excess foreskin. Methods： One thousand two hundred patients between the age of 5 and 95 years underwent circumcision using this procedure in the 2-year period between October 2005 and September 2007. Of these cases, 904 had excess foreskin and 296 were cases of phimosis. Results： In 96.33% of the cases the incision healed, leaving a minimal amount of the inner foreskin with no scarring and producing good cosmetic results. There were no incidents of device dislocation or damage to the frenulum. The average operative time was 2.5 min for excess foreskin, and 3.5 min for phimosis. During the 7 days of wearing the device, mild to moderate edema occurred in 10.08 % of cases with excess foreskin and in 2.58 % of those with phimosis. Edema in the frenulum was seen in 1.67% of patients, and only 0.67% had an infection of the incision. A total of 86.25% of patients reported pain due to penile erection. After removal of the device, 0.58% of the cases had minimal bleeding around the incision, and 2.42% had wound dehiscence. Conclusion： The new device can be applied to an overwhelming majority of patients with phimosis and excess foreskin. This technique is relatively simple to perform, and patients who underwent this surgery had very few complications. Antibiotics were not required and patients reported less pain than those who were circumcised using conventional methods. Circumcision with this device requires minimal tissue manipulation, and is quicker and safer than circumcision using conventional techniques.
文摘This systematic review assessed the safety and efficacy of the disposable circumcision suture device （DCSD） and conventional circumcision （CC） in the treatment of redundant prepuce and phimosis. Two independent reviewers conducted a literature search for randomized controlled trials （RCTs） using the DCSD and CC for the treatment of redundant prepuce or phimosis in China and abroad. Nine RCTs （1898 cases） were included. Compared with the CC group, the DCSD group had a shorter operative time （standardized mean difference [SMD] = -21.44; 95% confidence intervals [95% CIs] [-25.08, -17.79]; P 〈 0.00001）, shorter wound healing time （SMD = -3.66; 95% CI [-5.46, -1.85]; P 〈 0.0001）, less intraoperative blood loss （SMD = -9.64; 95% CI [-11.37, -7.90]; P 〈 0.00001）, better cosmetic penile appearance （odds ratio [OR] =8.77; 95% CI [5.90, 13.02]; P 〈 0.00001）, lower intraoperative pain score, lower 24-h postoperative pain score, lower incidence of infection, less incision edema, and fewer adverse events. There were no differences between the CC and DCSD groups in the incidences of dehiscence, or hematoma. The results of this meta-analysis indicate that the DCSD appears to be safer and more effective than CC. However, additional high-quality RCTs with larger study populations are needed.
