Department of Urology, The Second People's Hospital of Lianyungang, No.161, Xingfu Road, Haizhou District, Lianyungang, 222000, P.R.China.
Tianjin Medical University, No. 22, Qixiangtai Road, Tianjin, 300211, P.R. China.
Urol J. 2020 May 16;17(3):301-305. doi: 10.22037/uj.v0i0.4973.
Circumcision is a common human urologic surgery performed in males with redundant prepuce to prevent the transmission and reduce the risk of urologic diseases. However, the optimal circumcision method for elderly men remains to be determined. Herein, the current study was conducted to characterize the efficacy of four different kinds of circumcision for elderly males with redundant prepuce.
This retrospective study included 132 elderly males diagnosed with redundant prepuce who underwent circumcision at the outpatient department. Among them, 38 cases were subjected to traditional surgery (Group A), 23 cases to sleeve circumcision (Group B), and 42 cases to Shang Ring circumcision (Group C) and 29 cases to suturing device circumcision (Group D). Subsequently, the operation time, loss of blood, postoperative pain, complications, wound healing, and the satisfaction were respectively compared and analyzed.
The operation time of these 4 groups was calculated to be 27.3 ± 2.39 min, 30.4 ± 2.23 min, 6.3 ± 1.33 min, 7.6 ± 1.29 min, in Group A, Group B, Group C, Group D, respectively (P < 0.05). Besides, the loss of blood was 15.6 ± 2.84 mL, 11.8 ± 1.73 mL, 1.3 ± 0.44 mL, 3.7 ± 1.41 mL, respectively (P < 0.05). The elderly males who underwent Shang Ring circumcision exhibited the highest postoperative pain score, the longest pain duration, the longest healing time, the lowest recovery satisfaction rate and the highest operation experience satisfaction rate (P < 0.05).
Taken together, all four types of male circumcision present with advantages and drawbacks. The traditional male circumcision and sleeve circumcision led to longer operation time and more bleeding, but no additional medical equipment was needed. Meanwhile, the Shang Ring circumcision caused the shortest operation time and the least bleeding, accompanied by the longest pain duration and recovery time. Therefore, the application of sleeve circumcision or a suturing device was recommended for elderly males suffering from redundant prepuce.
割礼是一种常见的人类泌尿科手术，用于对有多余包皮的男性进行操作，以预防疾病传播和降低泌尿科疾病的风险。然而，对于老年男性来说，哪种割礼方法最优还需要进一步的研究。本研究旨在探讨四种不同的割礼方法对老年男性多余包皮的治疗效果。
本回顾性研究纳入了 132 名在门诊被诊断为有多余包皮的老年男性，他们均接受了割礼手术。其中 38 例接受传统手术（A 组），23 例接受套袖割礼（B 组），42 例接受商环割礼（C 组），29 例接受缝合器割礼（D 组）。随后，分别比较和分析了 4 组的手术时间、失血量、术后疼痛、并发症、伤口愈合情况和满意度。
A、B、C、D 组的手术时间分别为 27.3 ± 2.39 min、30.4 ± 2.23 min、6.3 ± 1.33 min、7.6 ± 1.29 min（P < 0.05），失血量分别为 15.6 ± 2.84 mL、11.8 ± 1.73 mL、1.3 ± 0.44 mL、3.7 ± 1.41 mL（P < 0.05）。商环割礼组的老年男性术后疼痛评分最高，疼痛持续时间最长，愈合时间最长，恢复满意度最低，手术体验满意度最高（P < 0.05）。
综上所述，四种男性割礼方法各有优缺点。传统割礼和套袖割礼手术时间较长，出血量较多，但无需额外的医疗设备。而商环割礼手术时间最短，出血量最少，但疼痛持续时间和恢复时间最长。因此，对于有多余包皮的老年男性，建议采用套袖割礼或缝合器。
