Examination of short and long term complications of thermocautery, plastic clamping, and surgical circumcision techniques

Abstract

Objective: In this study, thermocautery, plastic clamping, and conventional (open surgical) circumcision techniques were compared in terms of their complications.

Methods: Male patients who underwent circumcisions between May 2014 and May 2015 in two separate pediatric surgery clinics were retrospectively analyzed using the hospital registry system. These patients were evaluated in terms of age, accompanying pathologies, anesthesia techniques, complication rates, duration of surgery, and circumcision techniques. A statistical analysis of the data was performed, with a P<0.05 considered to be statistically significant.

Results: The patients were divided into three groups according to the circumcision method: conventional surgical circumcision (n=833), thermocautery (n=1011), and plastic clamp (n=218). Complications were observed in 21 cases (1%): bleeding (11), infection (2), trapped penis (6), meatitis (1), and scrotal injury (1). There were significantly fewer complications in the thermocautery technique when compared to the clamping and surgical circumcision techniques. The plastic clamping and thermocautery techniques were superior to a surgical circumcision in terms of the operation time.

Conclusion: The thermocautery circumcision technique can be used easily in both the operating theatre and in designated circumcision rooms, with a lower complication rate, when compared to plastic clamping and surgical circumcisions.

Keywords: Circumcision; Clamp; Complication; Pediatric; Thermocautery.

Fig. 1

Thermocautery device.

Fig.2

Circumcision with thermocautery technique. a, b)The foreskin was pulled up with the clamps, and the outer skin and mucosa were cut using a thermocautery device. c) Cauterization of dorsal vein; no bleeding was seen in the incision line after cutting the skin and mucosa. d) Postoperative appearance of the penis.

Fig.3

Complications. a) Alisklamp complication showing scrotal injury due to extensive cutting of the preputium with a scalpel after clamping. Arrow: circumcision line after the clamp removal. Dashed arrow: scrotal injury. b) Arrow: meatitis developed three months after the thermocautery application. c) Trapped penis after the open surgery technique. The same complication also developed after the Alisklamp and thermocautery techniques. Arrow: trapped glans. Dashed arrow: narrowing preputium in front of the glans penis.