Novel no-flip Shang Ring circumcision for adult males: a clinical application study of 528 cases / 中华男科学杂志

<p><b>OBJECTIVE</b>To evaluate the safety and clinical outcomes of the novel simplified no-flip surgical approach to Shang Ring male circumcision in adults.</p><p><b>METHODS</b>A total of 528 adult males, aged 18 - 58 (mean 35) years, 63 with phimosis and 465 with redundant prepuce, underwent no-flip Shang Ring circumcision with or without removal of the outer ring. The operation time and intraoperative blood loss were recorded and observations were made on such complications as postoperative bleeding, infection, edema, and wound dehiscence.</p><p><b>RESULTS</b>The operation time, intraoperative blood loss, and 2-hour postoperative pain score were (3.8 +/- 0.3) min, (0.6 +/- 0.1) ml, and 7.3 +/-0.3, respectively. Spontaneous ring detachment occurred at 21.6 +/- 2.1 days postoperatively in 12.7% of the patients (67/528) who had chosen not to remove the rings. Of those who preferred removal of the outer ring (87.3% [461/528]), none experienced any pain at the ring removal 7 days after the operation. Postoperative complications included infection in 3 cases (0.56%) and mild edema in 9 (1.70%), but no bleeding and wound dehiscence. Totally, 518 (98.1%) of the patients felt satisfied with the postoperative penile appearance.</p><p><b>CONCLUSION</b>No-flip Shang Ring circumcision, with no need for removal of the inner ring, is a safe and simple approach for adult males, which is superior to conventional Shang Ring circumcision for requirement of fewer surgical instruments, shorter operation time, lower incidence of complications, and better satisfaction with the penile appearance. However, these advantages are to be further demonstrated by more randomized controlled trials.</p>

Standardized male circumcision with Shang Ring reduces postoperative complications: a report of 351 cases / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the effect of standardized male circumcision with Shang Ring in reducing postoperative complications.</p><p><b>METHODS</b>We performed standardized male circumcision with Shang Ring for 351 males aged 4-58 (mean 31) years, 46 with phimosis and 305 with redundant prepuce, and observed the complications, including postoperative bleeding, infection, edema, and wound dehiscence.</p><p><b>RESULTS</b>The main complications included infection (5 cases, 1.42%), mild edema (9 cases, 2.56%), moderate edema (5 cases, 1.42%), and wound dehiscence (6 cases, 1.71%), but no postoperative bleeding was observed.</p><p><b>CONCLUSION</b>Using the standard protocol of circumcision with Shang Ring, well-trained male circumcision providers can significantly reduce postoperative complications and enhance the patient's satisfaction. Normalized training of the circumcision providers is essential for the popularization of standardized male circumcision with Shang Ring.</p>

Relationship of nitric oxide and nitric oxide synthase with varicocele infertility / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the relationship of nitric oxide (NO) and nitric oxide synthase (NOS) with varicocele (VC) infertility.</p><p><b>METHODS</b>Fifty-three infertile men, 21 with varicocele and 32 with subvaricocele, were enrolled as Group 1, 29 infertile patients with oligoasthenozoospermia but without varicocele as Group 2 and 28 normal fertile controls as Group 3. The NO content and NOS activity in the seminal plasma and peripheral blood were measured by nitric acid reductase method, and the semen parameters of VC determined by computer-assisted semen analysis (CASA).</p><p><b>RESULTS</b>Significant differences were noted between Group 1 and the other two in the NO content and NOS activity in the seminal plasma (P < 0.05) but not in the peripheral blood (P > 0.05). In Group 1, the NO content and NOS activity were increased in both the seminal plasma and peripheral blood with the enhanced diameter of the varicose spermatic vein, with a significant difference only in the seminal plasma between the varicocele and subvaricocele patients (P < 0.05), and the same increase was observed with decreased sperm concentration (> or = 20 x 10(6)/ml and < or = 10 x 10(6)/ml) and motility (> or = 50% and < or = 25%), with significant differences (P < 0.05).</p><p><b>CONCLUSION</b>NO plays an important role in the VC-induced decrease of seminal quality. For the diagnosis of VC, the determination of the NO content and NOS activity in the seminal plasma is of more significance than that in the peripheral blood, and the earlier the determination, the greater its clinical value for both the diagnosis and treatment of VC.</p>

Clinical application of a new device for minimally invasive circumcision / 亚洲男科学杂志(英文版)

<p><b>AIM</b>To study the clinical effects of a disposable circumcision device in treatment of male patients of different ages with either phimosis or excess foreskin.</p><p><b>METHODS</b>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.</p><p><b>RESULTS</b>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.</p><p><b>CONCLUSION</b>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.</p>