Cakiroglu Basri, Gozukucuk Ali, Arda Ersan, Tas Tuncay
Department of Urology, Hisar Intercontinental Hospital, Saray Mah, Siteyolu Cad.No.7-9, İstanbul 34768, Turkey.
Department of Pediatric Surgery, Hisar Intercontinental Hospital, İstanbul, Turkey.
Ther Adv Urol. 2019 Oct 13;11:1756287219882598. doi: 10.1177/1756287219882598. eCollection 2019 Jan-Dec.
The objective of this study was to evaluate the reliability of thermocautery-assisted circumcision performed voluntarily in patients of poor countries.
Between 2016 and 2019, 32,000 children aged 7 days to 17 years were circumcised in multiple countries. The patients' urological examinations were done before the administration of local anaesthesia. Patients revealed to have undescended testicle, inguinal hernia, hypospadias, varicocele, penile rotation anomaly, epispadias and infection were not circumcised. All procedures were performed under local anaesthesia by using thermocautery. Afterwards, mucosa and skin were sutured using absorbable suture and the circumcised penis was dressed. Patients were instructed to remove the dressing after 3 days.
Bleeding, requiring surgical intervention and drug reactions were not observed. The most observed complication was mucosal oedema, which occurred in approximately one-quarter of patients (26%, 8320/32,000) and continued for 3-5 days after the surgery. The most serious complication was a trapped penis, which occurred in 25 patients (0.078%). In six (0.018%) cases, meatal stenosis developed. Wound infection developed in only 10 (0.03%) cases, through the formation of an aseptic environment. Penile adhesion was seen in 35 cases (0.1%) and improved with anti-inflammatory treatment without any surgical intervention.
Thermocautery-assisted circumcision can be used as an effective, safe and useful technique with few complications and rapid healing rates.
本研究的目的是评估在贫穷国家自愿接受热灼环切术的可靠性。
2016年至2019年期间，多个国家的32000名7天至17岁的儿童接受了环切术。在局部麻醉给药前对患者进行了泌尿外科检查。发现有隐睾、腹股沟疝、尿道下裂、精索静脉曲张、阴茎旋转异常、尿道上裂和感染的患者未接受环切术。所有手术均在局部麻醉下使用热灼进行。之后，使用可吸收缝线缝合黏膜和皮肤，并对环切后的阴茎进行包扎。指示患者在3天后拆除包扎。
未观察到需要手术干预的出血和药物反应。最常观察到的并发症是黏膜水肿，约四分之一的患者（26%，8320/32000）出现这种情况，术后持续3至5天。最严重的并发症是阴茎绞窄，发生在25名患者中（0.078%）。6例（0.018%）出现尿道口狭窄。仅10例（0.03%）发生伤口感染，通过形成无菌环境实现。35例（0.1%）出现阴茎粘连，经抗炎治疗后改善，无需任何手术干预。
热灼环切术可作为一种有效、安全且实用的技术，并发症少，愈合速度快。
