Zhang Zheng, Yang Baibing, Yu Wen, Han Youfeng, Xu Zhipeng, Chen Hai, Chen Yun, Dai Yutian
Department of Andrology, Drum Tower Hospital, Affiliated to School of Medicine, Nanjing University, #321 Zhong Shan Road, Nanjing, 210008, China.
Int Urol Nephrol. 2016 Apr;48(4):465-73. doi: 10.1007/s11255-016-1213-3. Epub 2016 Jan 22.
To compare the surgical effects and postoperative complications and patient experience of two circumcision methods (novel disposable suture device and conventional suture approach) in Chinese excess foreskin or phimosis patients performed in our Andrology centre in a prospective non-randomized controlled study.
A total of 520 cases of excess foreskin and 62 phimosis patients that underwent circumcision between June 2014 and June 2015 in a single center using novel disposable device (n = 295; mean age 30.4 years, range 18-44 years) and conventional suture approach (n = 287; mean age 28.6 years, range 16-41 years) were documented. The main surgical outcomes (surgical time, intraoperative blood loss, incision healing time) and postoperative complications and patient experience (postoperative pain score, satisfaction rate of postoperative penile cosmetic appearance, recovery duration) were collected and analyzed. A multivariate logistic regression with likelihood ratio test was also used to observe the possible determinants of edema occurrence postoperatively.
The novel disposable suture device group had shorter operation time, lower pain score and rapid recovery and a higher satisfaction rate of penile cosmetic appearance when compared to the conventional circumcision group. Besides, the incidence of complications (hematoma and incision bleeding and infection) was significantly lower in the novel disposable suture device group. A multivariate logistic regression with likelihood ratio test revealed that phimosis was the significant predictor of edema occurrence postoperatively (Chi square of likelihood ratio = 9.88, df = 1, p = 0.025).
Circumcision using this novel disposable suture device is associated with short operative time, rapid recovery, less pain experience, less complications (hematoma and incision bleeding and infection) and high satisfaction rate of penile appearance. This new approach should be of value for future application. Phimosis patients should be notified that they had a great possibility to develop edema postoperatively regardless of the surgical options.
在一项前瞻性非随机对照研究中,比较在我们男科中心为中国包皮过长或包茎患者实施的两种包皮环切术方法(新型一次性缝合装置和传统缝合方法)的手术效果、术后并发症及患者体验。
记录了2014年6月至2015年6月在单一中心使用新型一次性装置(n = 295;平均年龄30.4岁,范围18 - 44岁)和传统缝合方法(n = 287;平均年龄28.6岁,范围16 - 41岁)进行包皮环切术的520例包皮过长患者和62例包茎患者。收集并分析主要手术结果(手术时间、术中出血量、切口愈合时间)、术后并发症及患者体验(术后疼痛评分、术后阴茎外观满意度、恢复持续时间)。还使用似然比检验的多变量逻辑回归来观察术后水肿发生的可能决定因素。
与传统包皮环切术组相比,新型一次性缝合装置组手术时间更短、疼痛评分更低、恢复更快且阴茎外观满意度更高。此外,新型一次性缝合装置组并发症(血肿、切口出血和感染)的发生率显著更低。似然比检验的多变量逻辑回归显示,包茎是术后水肿发生的显著预测因素(似然比卡方 = 9.88,自由度 = 1,p = 0.025)。
使用这种新型一次性缝合装置进行包皮环切术具有手术时间短、恢复快、疼痛体验少、并发症(血肿、切口出血和感染)少以及阴茎外观满意度高的特点。这种新方法对未来应用应具有价值。应告知包茎患者,无论选择何种手术方式,他们术后发生水肿的可能性都很大。