“…Compared with the conventional circumcisions, circumcisions with the DCSD have obvious advantages of shorter operation time, less blood lose, better satisfaction, lower pain level, and better cosmetic appearance and also a clear disadvantage of higher price owing to the cost of the DCSD. 12 , 13 , 14 , 15 As a result, the DCSD is widely used in more and more medical institutions. However, there are still different conclusions on the blood loss; as reported, there is more intraoperative blood loss and a few cases of severe postoperative bleeding, 12 , 17 while another conclusion indicates that circumcisions with the DCSD experienced significantly less intraoperative blood loss compared with conventional circumcisions.…”
Section: Discussionmentioning
confidence: 99%
“…The procedures have also been well described by other articles. 12 , 13 , 16 Then, the circular wound was dressed with a self-adhesive flexible bandage ( Figure 2 A and 2B ). Figure 2 (A) View of the dorsal part of pressure dressing in group A.…”
Section: Methodsmentioning
confidence: 99%
“…However, bleeding with circumcision has always been a crucial problem and drawn much attention, 8 especially in patients with bleeding disorders [9] , 10 , 11 or with lichen sclerosus. 12 …”
Introduction
A novel type of a disposable circumcision suture device (DCSD) has been proved to be effective and safe; however, a few cases of severe bleeding took place after circumcisions.
Aim
To evaluate the effectiveness of a modified double-layer pressure dressing to avoid severe bleeding after circumcision with the DCSD, in our department in a prospective randomized controlled study, and discuss the mechanism of bleeding with DCSD.
Methods
Patients with redundant foreskin or phimosis were included between September 2018 and November 2019 and divided into 2 groups: In group A, the conventional pressure dressing was performed; in group B, an modified double-layer pressure dressing was performed.
Main Outcome Measure
The main outcomes and complications (surgical time, incidence of glans ischemia, severe bleeding rate, infection rate, pain level, total cost, and overall satisfaction) were collected and analyzed.
Results
A total of 624 patients were recruited for this study. There was no difference in the average age and body mass index between 2 groups. No patient suffered obvious glans ischemia. In group B, lower pain level, lower incidences of severe bleeding, and better satisfaction were recorded.
Conclusion
The mechanism of bleeding with the DCSD was discussed in this study, and the modified pressure dressing was proved effective, safe, and easy to perform.
W Jiang, J-li Fu, W-l Guo, et al. A Modified Pressure Dressing to Avoid Severe Bleeding After Circumcision With a Disposable Circumcision Suture Device and a Discussion on the Mechanism of Bleeding With the Disposable Circumcision Suture Device. Sex Med 2021;9:100288.
“…Compared with the conventional circumcisions, circumcisions with the DCSD have obvious advantages of shorter operation time, less blood lose, better satisfaction, lower pain level, and better cosmetic appearance and also a clear disadvantage of higher price owing to the cost of the DCSD. 12 , 13 , 14 , 15 As a result, the DCSD is widely used in more and more medical institutions. However, there are still different conclusions on the blood loss; as reported, there is more intraoperative blood loss and a few cases of severe postoperative bleeding, 12 , 17 while another conclusion indicates that circumcisions with the DCSD experienced significantly less intraoperative blood loss compared with conventional circumcisions.…”
Section: Discussionmentioning
confidence: 99%
“…The procedures have also been well described by other articles. 12 , 13 , 16 Then, the circular wound was dressed with a self-adhesive flexible bandage ( Figure 2 A and 2B ). Figure 2 (A) View of the dorsal part of pressure dressing in group A.…”
Section: Methodsmentioning
confidence: 99%
“…However, bleeding with circumcision has always been a crucial problem and drawn much attention, 8 especially in patients with bleeding disorders [9] , 10 , 11 or with lichen sclerosus. 12 …”
Introduction
A novel type of a disposable circumcision suture device (DCSD) has been proved to be effective and safe; however, a few cases of severe bleeding took place after circumcisions.
Aim
To evaluate the effectiveness of a modified double-layer pressure dressing to avoid severe bleeding after circumcision with the DCSD, in our department in a prospective randomized controlled study, and discuss the mechanism of bleeding with DCSD.
Methods
Patients with redundant foreskin or phimosis were included between September 2018 and November 2019 and divided into 2 groups: In group A, the conventional pressure dressing was performed; in group B, an modified double-layer pressure dressing was performed.
Main Outcome Measure
The main outcomes and complications (surgical time, incidence of glans ischemia, severe bleeding rate, infection rate, pain level, total cost, and overall satisfaction) were collected and analyzed.
Results
A total of 624 patients were recruited for this study. There was no difference in the average age and body mass index between 2 groups. No patient suffered obvious glans ischemia. In group B, lower pain level, lower incidences of severe bleeding, and better satisfaction were recorded.
Conclusion
The mechanism of bleeding with the DCSD was discussed in this study, and the modified pressure dressing was proved effective, safe, and easy to perform.
W Jiang, J-li Fu, W-l Guo, et al. A Modified Pressure Dressing to Avoid Severe Bleeding After Circumcision With a Disposable Circumcision Suture Device and a Discussion on the Mechanism of Bleeding With the Disposable Circumcision Suture Device. Sex Med 2021;9:100288.
“…Steroids have been shown to limit the progression of the disease, but do not offer an overall cure. 10,11 Some studies recommend the use of steroid creams for voiding discomfort post-circumcision. Surgery appears to be the only treatment for advanced disease, and steroid creams are ineffective in established scarring.…”
Section: Discussionmentioning
confidence: 99%
“…Histological features commonly show atrophy of the epidermis, subepithelial sclerosis with band-like inflammation. 10 In the pediatric population, circumcision is the treatment of choice. 11 There is no definitive role of topical steroids in BXO although some papers have shown that it is effective at reducing progression of BXO in the early stages of the disease.…”
Clinical correlation by surgeons has a high degree of accuracy (>90%). Meatal involvement is more common than previously reported. The use of pre- or postoperative steroids does not obviate the need for further surgical procedures. Patients can have recurrent symptoms 1 year following surgery, and prolonged follow-up is necessary.
Background and Aims
Major circumcision complications are rare; however, circumcision arouses distress in some special cases. The present study aimed to compare infancy and childhood regarding the frequency and relative risk of early and late complications of circumcision.
Methods
This study was a retrospective cohort data analysis including 240 neonates and 240 children referred for circumcision from 2015 to 2021. All circumcisions were performed using the surgical dorsal‐ventral slits method. A Cox proportional hazard model was used to assess the relative risk (RR) of complications at a confidence Interval of 95%.
Results
The mean age was 19.32 ± 6.5 days for the neonates and 46.1 ± 8.8 months for the children. In general, complications occurred in 61 boys (12.7%), 40 neonates (8.3%), and 21 children (4.4%) (
p
˂0.001). Bleeding was the most common early complication in six neonates (2.5%) and three children (1.3%), and meatal stenosis was the most common late complication in 10 neonates (4.2%) and four children (1.6%). Meatal web was observed in 11 neonates (4.6%) and four children (1.6%), and the incomplete removal of the prepuce, as “not very satisfactory”, was also noticed in nine neonates (3.75%) and three children (1.3%). The circumcision complications were significantly more frequent in neonates than in children (RR = 2.6, 95% CI 1.46‐4.71,
p
<0.001). The neonatal circumcisions had a significant risk of the incomplete removal of the prepuce, meatal web, and meatal stenosis compared to children (RR = 3, 95% CI 5.83–10.81,
p
<0.04; RR = 2.75, 95% CI 0.9–8.3,
p
˂0.03; RR = 2.5, 95% CI 0.8–7.75,
p
<0.04, respectively).
Conclusion
The risk of complications is higher in neonates than children. The incomplete removal of prepuce, meatal web, and meatal stenosis are significantly higher in neonates than in children. Before prohibiting or recommending this procedure, practitioners should provide comprehensive information about its risks and benefits. Parents should weigh up the risks and benefits and make the best decision regarding their personal beliefs and customs.
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