Comparison of the results of two different circumcision techniques: Surgical technique vs. a novel plastic clamp technique
Elif Emel Erten, Ayşe Karaman, İbrahim Karaman, Engin Yılmaz, Çağatay Evrim Afşarlar, Ahmet Ertürk, Meryem Anayurt, İsmet Faruk Özgüner, Yusuf Hakan Çavuşoğlu, Derya Erdoğan
Dr. Sami Ulus Kadın Doğum, Çocuk Sağlığı ve Hastalıkları, Eğitim ve Araştırma Hastanesi Çocuk Cerrahisi Bölümü, Ankara
Keywords: Circumcision, open surgical technique, clamp circumcision, circumcision complications
Abstract
Objective: Circumcision is the surgical removal of the foreskin (prepuce) that covers the tip of the penis. The aim of this study was to compare the results of surgical circumcision and circumcision with a circumcision clamp (Alisklamp®).
Material and Method: A retrospective chart review of patients who underwent circumcision in our clinic between January 2010 and December 2011 was performed. Patients were divided into two groups as surgical circumcision and circumcision with clamp. Groups were considered in terms of operating time, outcomes, cost-effectiveness and postoperative complications.
Results: During the study period circumcision was performed on 911 patients with a mean age of 4.5±2.9 years. Open surgical technique was used in 78 % (n=707) of the patients, and circumcision clamp was used in 22 % of them (n=204). Circumcision was performed on 471 patients (52 %) primarily and 440 patients (48 %) in addition to inguinoscrotal operations. The mean operation time was 25±5 minutes with surgical circumcision and 11±4 minutes with circumcision clamp application (p<0.001). While the cost of circumcision with surgical circumcision was 175±35 Turkish liras (TL), and of of clamp circumcision was 130±32 TL (p<0.001). The most common complications of clamp circumcision were post circumcision phimosis (n=2, 1 %), bleeding (n=1, 0.5 %) and post-circumcision urethral fistula (n=1, 0.5 %) respectively. Wound infection was the most frequent complication in patients undergoing surgical circumcision (n=4, 0.6 %), while bleeding (n=3, 0.4 %) and secondary phimosis (depending on the technique) (n=2, 0.3 %) were rarely encountered.
Conclusion: Both clamp circumcision and open surgical technique have successful cosmetic results and low complication rates in safe hands. In recent years clamp circumcision has been a preferred method in our clinic owing to being an easily applicable technique with successful outcomes and low cost. However, it must be emphasized that occasional problems such as wound infection, urethral fistula could be seen.