Penile protection with a self-developed flexible sleeve penile protection device after circumcision: a prospective randomized controlled trial / 现代泌尿外科杂志

【Objective】 To investigate the protective effects of aflexible sleeve penile protection device on reducing postoperative pain and wound edema in patients after circumcision. 【Methods】 A total of 54 patients who underwent circumcision at Yan’an Branch of Peking University Third Hospital during Feb.1 and May 31, 2023 were enrolled.The patients were randomly divided into the experimental group and control group, with 27 patients in either groups.Patients in the experimental group were treated with a flexible sleeve penis protection device after surgery, and patients in the control group were treated with traditional gauze bandage after surgery.Postoperative pain, wound edema and complications were compared between the two groups. 【Results】 In terms of pain, the visual analogue scale of the experimental group was significantly lower at 6 hours [(1.7±0.9) vs.(3.3±1.9), P0.05).In terms of edema, the edema score of the experimental group was significantly lower than that of the control group on the 2nd postoperative day [(2.0±1.0) vs.(4.0±0.8), P0.05). 【Conclusion】 The flexible sleeve penile protection device has significant effects of reducing early postoperative pain and reducing edema in patients undergoing circumcision.

HPV infection of the external genitalia in men whose female partners have cervical HPV infection / 中华男科学杂志

<p><b>Objective</b>Human papilloma virus (HPV) is a necessary cause of cervical cancer and is also closely related to penile cancer, oropharyngeal cancer, and anal cancer in males. However, few studies are reported on male HPV. This study aimed to investigate HPV infection of the external genitalia in men whose female partners have cervical HPV infection.</p><p><b>METHODS</b>We collected the relevant data on the male outpatients whose partners had cervical HPV infection in our Department of Urology and Andrology from August to December 2016. We obtained samples with nylon swabs from the glans penis, corona, inner layer of the prepuce and penile body and detected different types of HPV infection using the Hybribio HPV typing kit, PCR and membrane hybridization.</p><p><b>RESULTS</b>Valid data were collected from 140 males, which showed 83.5% of HPV infection of the external genitalia, including 60 cases of HPV6 (43.2%), 27 cases of HPV16 (19.4%), 14 cases of HPV39 (10.1%), 13 cases of HPV18 (9.4%), 13 cases of HPV58 (9.4%), and 13 cases of HPV52 (9.4%). Redundant prepuce was found in 75.5% of the males, but there was no statistically significant difference in the incidence rate of HPV infection between the normal and redundant prepuce groups (P > 0.05).</p><p><b>CONCLUSIONS</b>Men who have the female partners with positive cervical HPV are at high risk of HPV infection and therefore need to be screened and treated so as to reduce HPV infection in both sexes.</p>

Clinical effect of two-person of and one-person operations of disposable circumcision stitching instrument / 国际外科学杂志

Objective To compare the clinical effect of two-person operations of disposable circumcision stitching instrument and one-man operations of disposable circumcision stitching instrument.Methods Clinical data of 340 patients with redundant prepuce or phimosis from March 2015 to August 2017 were randomly divided into control group which patients with two-person operation of disposable circumcision stitching instrument and study group which patients with one-man operation of disposable circumcision stitching instrument were reviewed prospectively.There were 188 patients in the study group,including 22 patients with phimosis and 166 patients with redundant prepuce;Among the 152 patients in the control group,there were 17 cases with phimosis and 135 cases with redundant prepuce.Two groups with operation time,intraoperative blood loss,postoperative skin staple missing,2 hours postoperative pain,postoperative edema,the swelling subsided time,postoperative complications,postoperative patient satisfaction,and so on.Measurement data were represented as (x) ± s,and comparison between groups was analyzed using t test;count data were represented as percentage and comparison between groups was analyzed chi-square.Results All operations were finished successfully for the patients by two-person or one-man of operations of disposable circumcision stitching instrument.In terms of operation,the operation time of the observation group and the control group was (7.76 ±0.45) minutes and (7.86 ±0.91) minutes respectively,and the difference was not statistically significant(P ＞ 0.05).Intraoperative hemorrhage of observation group and control group were (1.77 ± 0.22) ml and (1.72 ± 0.26) ml,and the difference was not statistically significant (P ＞ 0.05).There was no statistically significant difference between the observation group and the control group (P ＞ 0.05) in the postoperative 2 hours pain score and skin staple missing.In the postoperative complications,the deviation rate of the prepuce was 1.11％,significantly lower than the control group 5.92％,and the difference was statistically significant (P ＜ 0.05).There was no statistically significant difference between the observation group and the control group in terms of edema on the third postoperative day,short postoperative anastomosis,patient satisfaction,and postoperative infection.Conclusion The way of one-man operation of disposable circumcision stitching instrumente not only saves labor costs,but also has a good postoperative clinical effect,meanwhile,it has high efficiency and strong operability,and is worthy of promotion for clinical first-line urologists.

Use of a disposable circumcision suture device versus conventional circumcision: A systematic review and meta-analysis / 亚洲男科学杂志(英文版)

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.

Frenulum identification positioning with a disposable suture device in circumcision to prevent postoperative penile frenulum malposition / 中华男科学杂志

Objective@#To investigate the effect of the frenulum identification positioning method with a disposable suture device in circumcision for the prevention of postoperative penile frenulum malposition.@*METHODS@#Totally 212 patients with phimosis or redundant prepuce underwent circumcision from March 2015 to September 2016, including 109 cases of conventional circumcision (the control group) and 103 cases treated by frenulum identification positioning with a disposable suture device (the observation group). We observed the postoperative position of the penile frenulum and median raphe and compared the deviation angles of the frenulum between the two groups of patients.@*RESULTS@#The median of penile frenulum deviation angle (interquartile range) was 0 (3.56) in the observation group, significantly smaller than 12.41 (19.59) in the control (P <0.001, P = 0.000). And the rate of frenulum deviation was remarkably lower in the former (8.74% ［9/103］) than in the latter group (66.06% ［72/109］) (P <0.01).@*CONCLUSIONS@#Circumcision using the frenulum identification positioning method with a disposable suture device can effectively avoid postoperative penile frenulum malposition. With the advantages of safety and easy operation, it deserves clinical application and popularization.

A novel disposable ring versus the suture device in circumcision / 中华男科学杂志

Objective@#To investigate the clinical effect of a novel disposable ring versus that of the suture device in circumcision for redundant prepuce and phimosis.@*METHODS@#We randomly assigned 470 male patients with redundant prepuce or phimosis to receive circumcision with a novel disposable ring (the DR group, n = 235) or the suture device (the SD group, n = 235) and compared the operation time, intraoperative blood loss, pain scores, wound healing time, and postoperative complications and penile appearance between the two groups of patients.@*RESULTS@#All the operations were completed smoothly. Compared with the SD group, the DR group showed significantly shorter operation time (［7.49 ± 1.84］ vs ［3.83 ± 0.42］ min, P 0.05) or while the staples scraping the underpants or at the ring removal (3.49 ± 1.22 vs 3.36 ± 1.41, P >0.05). No obvious postoperative infection or delayed healing was observed except for 3 cases of wound dehiscence (1 in the DR and 2 in the SD group) and 8 cases of delayed removal of the staples in the SD group.@*CONCLUSIONS@#The novel disposable ring, with its advantages of short operation time, less bleeding and pain, good penile appearance, high safety, and simple operation, is obviously superior to the suture device in circumcision and deserves to be applied and popularized clinically. .

Shang Ring scissor circumcision versus electrotome circumcision for redundant prepuce / 中华男科学杂志

<p><b>Objective</b>To compare the clinical effects of Shang Ring scissor circumcision (SC) and electrotome circumcision (EC) in the treatment of redundant prepuce or phimosis.Methods: Results: Conclusion.</p><p><b>METHODS</b>This retrospective study included 524 patients with redundant prepuce or phimosis, 422 treated by SC and 120 by EC. We made comparisons between the two groups of patients in the operation time, intra- and post-operative pain scores, pain scores before, at and after ring removal, wound healing time, and incidence rates of postoperative edema and incision dehiscence.</p><p><b>RESULTS</b>The operation time was longer in the SC than in the EC group (［59.99±5.39］ vs ［39.94±4.94］ sec, P<0.05), but there were no significant differences between the two groups in the intraoperative pain scores (1.02±0.74 vs 1.08±0.59, P>0.05) or the pain scores within 24 h after operation (6.74±1.01 vs 6.56±1.06, P>0.05), 24 h prior to ring removal (1.14±0.69 vs 1.10±0.64, P>0.05), and after ring removal (2.73±0.74 vs 2.85±0.75, P>0.05) except at ring removal, which was remarkably lower in the SC than in the EC group (3.56±0.47 vs 4.77±0.58, P<0.05). The wound healing time was markedly shorter in the former than in the latter (［14.11±1.26］ vs ［39.78±7.55］ d, P<0.05), but the incidence rate of incision dehiscence showed no significant difference between the two groups (4.03% ［17/422］ vs 9.17% ［11/120］, P>0.05). The rate of postoperative satisfaction with the external penile appearance was 100% in both of the two groups.</p><p><b>CONCLUSIONS</b>Shang Ring scissor circumcision is preferred to electrotome circumcision for its advantages of less pain at ring removal and shorter healing time despite its longer operation time.</p>

Circumcision with "no-flip Shang Ring" and "dorsal Slit" methods for adult males: A single-centered, prospective, clinical study / 亚洲男科学杂志(英文版)

This paper was aimed to compare the clinical effectiveness and safety of adult male circumcision using the Shang Ring™ (SR) with the no-flip technique compared with Dorsal Slit (DS) surgical method. A single-centered, prospective study was conducted at the West China Hospital, where patients were circumcised using the no-flip SR (n = 408) or the DS (n = 94) procedure. The adverse events (AEs) and satisfaction were recorded for both groups, and ring-removal time and percentage of delayed removals were recorded for the SR group. Finally, complete follow-up data were collected for 76.1% of patients (SR: n = 306; DS: n = 76). The average ring-removal time for the SR group was 17.62 ± 6.30 days. The operation time (P < 0.001), pain scores during the procedure (P < 0.001) and at 24 h postoperatively (P < 0.001), bleeding (P = 0.001), infection (P = 0.034), and satisfaction with penile appearance (P < 0.001) in the SR group were superior to those in the DS group. After two postoperative weeks, the percentage of patients with edema in the SR group (P = 0.029) was higher but no differences were found at 4 weeks (P = 0.185) between the two groups. In conclusions, the no-flip SR method was found to be superior to the DS method for its short operation time (<5 min), involving less pain, bleeding, infection, and resulting in a satisfactory appearance. However, the time for recovery from edema took longer, and patients may wear device for 2-3 weeks after the procedure.

Applications of disposable circumcision stapler with lidocaine cream combined with lidocaine injection anesthesia in circumcision / 中华泌尿外科杂志

Objective To investigate the application efficacy of disposable circumcision stapler with compound lidocaine cream combined with lidocaine injection in the circumcision.Methods From September 2013 to November 2014,120 cases (11 cases of redundant prepuce phimosis patients), were divided into disposable circumcision suture group (S group, 60 cases) and conventional circumcision (T group, 60 eases) ,two groups had no statistically significant difference at patient age and wrapping case (6 cases phimosis of S group,5 cases phimosis of T group) (P ＞0.05.Patient's age ranged from 11 to 49 years.30 patients in each group were treated with lidocaine cream combined with lidocaine injection,and another 30 patients were treated with a local anesthetic lidocaine injection.Comparisons were conducted among the four groups on the operation time, anesthesia, intraoperative and postoperative pain score, blood loss and postoperative complications, postoperative appearance satisfaction, wound healing time.Results For the disposable circumcision stapler with lidocaine cream combined with lidocaine injection group, disposable circumcision stapler with lidocaine injection group, sleeve circumcision with lidocaine cream combined with lidocaine injection group and sleeve circumcision with lidocaine injection group, the operation time was (5.3 ± 1.5) min, (4.9 ± 1.4) min, (31.6 ± 3.4) min, (32.0 ± 3.3) min respectively, blood loss was (0.6 ± 0.4) ml, (0.8 ± 0.5) ml, (6.9 ± 2.4) ml, (7.5 ± 2.1) ml respectively, narcotic pain score was 0.6 ± 0.6,3.2 ±3.9,2.5 ± 1.0,0.5 ±0.6,intraoperative pain score was 0.8 ±0.9,1.4 ±0.8,2.2 ± 1.1,3.1 ± 1.1,postoperative 24 h pain score was 1.6 ±0.9,2.2 ±0.8,2.6 ± 1.3,4.4 ± 1.1, postoperative 48h pain score was 0.7 ±0.6,0.8 ±0.9,2.4 ±0.8,2.8 ±0.7, wound healing time was (13.7 ±1.5)d,(13.5 ± 1.7)d, (14.2 ± 1.3) d, (14.1 ± 1.6) d, the rate of postoperative complications was 6.6％ (2/30), 10.0％ (3/30),26.6％ (8/30), 33.4％ (10/30), satisfaction rate of appearance was 93.4％ (28/30), 96.7％ (29/30),70.4％ (22/30), 80.0％ (24/30).Compared with sleeve circumcision with lidocain injection group,disposable circumcision stapler with lidocaine cream combined with lidocaine injection had a shorter operation time, less pain, less bleeding, higher appearance satisfaction rate and lower incidence of complications (P ＜ 0.05), wound healing time had no significant difference (P ＞ 0.05).Conclusion Application of the disposable circumcision stapler with lidocaine cream combined with lidocaine injection on circumcision is safe and has got better clinical outcomes.

Observations on Meissner's corpuscle in prepuces of different ages / 中华泌尿外科杂志

Objective To observe Meissner's corpuscles in prepuces of different shapes and ages. Methods The Meissner's corpuscles were detected with immunohistochemical stain in 204 prepuce sam- ples of different shapes and ages (3-59 years),and the density of Meissner's corpuscles in every sample was obtained as well.The difference of Meissner's corpuscle densities between phimosis and redundant pre- puce,and correlation between Meissner's corpuscle densities and ages were analyzed with Chi-square test and linear regression,respectively.Results The density of Meissner's corpuscles in redundant prepuce has begun to increase since infancy and reached the peak at the age about 15 years.No significant difference in densities of Meissner's corpuscles between phimosis and redundant prepuce was observed till the age of 20 years,and then there was a trend of disappearance of Meissner's corpuscles in redundant prepuce.A signifi- cantly negative correlation between the densities of Meissner's corpuscles and ages was revealed in redundant prepuce (r=-0.236,P=0.009),whereas an insignificantly positive correlation between the densities of Meissner's corpuscles and ages was shown in phimosis (r=0.193,P=0.084).Conclusions The den- sities of Meissner's corpuscles in redundant prepuce develop synchronically with genital differentiation and accord with the status of sexual function in adult males.The persistent high level of Meissner's corpuscles in adult phimosis might be a mechanism of physiological compensation.

Circumcision of the root skin of penis for the treatment of redundant prepuce / 中华泌尿外科杂志

Objective To introduce the operative mode of circumcision of the root skin of penis for the treatment of redundant prepuce and its efficacy. Methods The operative indications included redundant prepuce and imperfect phimosis.With the will of patients,circumcision of the root skin of penis was performed on 256 cases of redundant prepuce and imperfect phimosis (group A).One section of the root skin of penis was resected,and the wound was sewed up.The skin of penis was moved from far to nearby and the prepuce was shortened finally.Compared with group A,group B (another 265 cases with the same indications) were treated with the traditional circumcision of prepuce.The amount of bleeding during operation and postoperative complications (bleeding, hematoma, dropsy, pain, infection of wound) were compared between the 2 groups. Results Intraoperative hemorrhagic amount was (3?1)ml in group A and (10?2)ml in group B( t=-50.36,P