medigraphic.com
Organo Oficial de la Sociedad Mexicana de Urología

2026, Number 2

<< Back Next >>

Rev Mex Urol 2026; 86 (2)

Classic versus mechanical circumcision in boys. Initial results of a prospective randomized study

Blanco-Verdú MD, Bada-Bosch I, Ordóñez-Pereira J, Fernández-Bautista B, Ortiz-Rodríguez R, Burgos-Lucena L, Angulo-Madero JM

Language: Spanish
References: 22
Page: 1-14
PDF size: 667.11 Kb.


ABSTRACT

Objective: to compare the clinical and aesthetic results of mechanical circumcision with stapler versus the classic technique in the pediatric population.
Methodology: prospective, randomized, single-center study. Fifty children between 6 and 16 years old with indication for circumcision were included, randomly assigned to classic (n = 25) or mechanical (n = 25) technique. Operative, postoperative and satisfaction variables were analyzed by Student’s t-test and chi-square.
Results: both techniques showed similar results in age, pain, postoperative complications, return to activities and satisfaction of patients, parents and surgeons. Surgical time was significantly shorter with the mechanical technique (10.4 vs. 19.7 min; p ‹ 0.0001), as well as the incidence of asymmetry (0 % vs. 24 %; p = 0.013). No serious complications were recorded. Limitations of the study: the study has a small sample size and does not perform an economic evaluation.
Originality: this work is among the first studies that prospectively and randomly compare mechanical circumcision versus the classic technique in the pediatric population. In a context of very limited literature, this work emerges as a relevant contribution to evaluate the feasibility and safety of mechanical devices in pediatric circumcision.
Conclusions: mechanical circumcision appears to be a safe and effective alternative to classical circumcision techniques in the pediatric population, significantly reducing surgical time and improving symmetry, with comparable de omplication and satisfaction rates.


REFERENCES

  1. Hohlfeld A, Ebrahim S, Shaik MZ, KredoT. Circumcision devices versus standardsurgical techniques in adolescent and adultmale circumcisions. The Cochrane Database ofSystematic Reviews. 2021;3(3): CD012250. https://doi.org/10.1002/14651858.CD012250.pub2.

  2. Rao JM, Huang H, Chen T, Yang CG, PanCZ, Deng GC, et al. Modified CircumcisionUsing the Disposable Circumcision SutureDevice in Children: A Randomized ControlledTrial. Urology. 2020;143: 206–211. https://doi.org/10.1016/j.urology.2020.06.018.

  3. Jiang Z, Chen H, Wu M, Li I, Li H, Jiang M, etal. Safety and Efficacy of Circumcision Stapler inthe Treatment for Children with Phimosis andRedundant Prepuce. Open Journal of Urology.2018;8(9): 263–266. https://doi.org/10.4236/oju.2018.89029.

  4. Wang J, Zhou Y, Xia S, Zhu Z, Jia L, Liu Y, etal. Safety and efficacy of a novel disposablecircumcision device: A pilot randomizedcontrolled clinical trial at 2 centers. MedicalScience Monitor. 2014;20: 454–462. https://doi.org/10.12659/MSM.889722.

  5. Clavien PA, Barkun J, de Oliveira ML,Vauthey JN, Dindo D, Schulick RD, et al.The Clavien-Dindo classification of surgicalcomplications: five-year experience. Annals ofSurgery. 2009;250(2): 187–196. https://doi.org/10.1097/SLA.0b013e3181b13ca2.

  6. Krill AJ, Palmer LS, Palmer JS. Complicationsof circumcision. TheScientificWorldJournal.2011;11: 2458–2468. https://doi.org/10.1100/2011/373829.

  7. Chou AC, Laih CY, Ku FY. A RetrospectiveTaiwanese-Population-Based Clinical Studyon Determining the Efficacy and Safety ofDisposable Circumcision Anastomat. Journal ofClinical Medicine. 2022;11(20): 6206. https://doi.org/10.3390/jcm11206206.

  8. World Health Organization. Male Circumcisionfor HIV Prevention: WHO Technical AdvisoryGroup on Innovations in Male Circumcision:Evaluation of two adult devices. 2013.

  9. Craig JC, Knight JF, Sureshkumar P, MantzE, Roy LP. Effect of circumcision on incidenceof urinary tract infection in preschool boys.The Journal of Pediatrics. 1996;128(1):23–27. https://doi.org/10.1016/s0022-3476(96)70423-7

  10. Bailey RC, Moses S, Parker CB, Agot K,Maclean I, Krieger JN, et al. Male circumcisionfor HIV prevention in young men in Kisumu,Kenya: a randomised controlled trial. Lancet.2007;369(9562): 643–656. https://doi.org/10.1016/S0140-6736(07)60312-2.

  11. Gray RH, Kigozi G, Serwadda D, Makumbi F,Watya S, Nalugoda F, et al. Male circumcisionfor HIV prevention in men in Rakai, Uganda:a randomised trial. Lancet. 2007;369(9562):657–666. https://doi.org/10.1016/S0140-6736(07)60313-4.

  12. Daling JR, Madeleine MM, Johnson LG,Schwartz SM, Shera KA, Wurscher MA, etal. Penile cancer: importance of circumcision,human papillomavirus and smoking in in situand invasive disease. International Journal ofCancer. 2005;116(4): 606–616. https://doi.org/10.1002/ijc.21009.

  13. Arunachalam P, King PA, Orford J. Aprospective comparison of tissue glue versussutures for circumcision. Pediatric SurgeryInternational. 2003;19(1–2): 18–19. https://doi.org/10.1007/s00383-002-0893-1.

  14. Alanis MC, Lucidi RS. Neonatal circumcision:a review of the world’s oldest and mostcontroversial operation. Obstetrical &Gynecological Survey. 2004;59(5): 379–395. https://doi.org/10.1097/00006254-200405000-00026.

  15. Jin XD, Lu JJ, Liu WH, Zhou J, Yu RK, Yu B,et al. Adult male circumcision with a circularstapler versus conventional circumcision: Aprospective randomized clinical trial. BrazilianJournal of Medical and Biological Research= Revista Brasileira De Pesquisas Medicas EBiologica. 2015;48(6): 577–582. https://doi.org/10.1590/1414-431X20154530.

  16. World Health Organization. FrameworkFor Clinical evaluation of Devices for maleCircumcision. 2012.

  17. Huo ZC, Liu G, Li XY, Liu F, Fan WJ, GuanRH, et al. Use of a disposable circumcisionsuture device versus conventional circumcision:a systematic review and meta-analysis. AsianJournal of Andrology. 2017;19(3): 362–367.https://doi.org/10.4103/1008-682X.174855.

  18. Huo Z chao, Liu G, Wang W, He D guang, YuH, Fan W ju, et al. Clinical effect of circumcisionstapler in the treatment of phimosis andredundant prepuce. Zhonghua Nan Ke Xue =National Journal of Andrology. 2015;21(4):330–333.

  19. Miao H dong, Lu J wei, Lu F nian, Shen F,Yuan X lin, Liu H yong. Clinical effects of thecircumcision stapler, foreskin cerclage, andtraditional circumcision: A comparative study.Zhonghua Nan Ke Xue = National Journal ofAndrology. 2015;21(4): 334–337.

  20. Pozza D, Pozza C, Mosca A, Pozza M.Preputial circumcision performed with a newmechanical stapling tool. The ‘langhe disposablecircumcision suture device’. Preliminaryexperiences. Archivio Italiano Di Urologia,Andrologia: Organo Ufficiale [di] SocietaItaliana Di Ecografia Urologica E Nefrologica.2020;91(4): 261–262. https://doi.org/10.4081/aiua.2019.4.261.

  21. Jiang W, Fu J li, Guo W liang, Yan Z chun,Zheng R qiang, Lu J ru, et al. A ModifiedPressure Dressing to Avoid Severe BleedingAfter Circumcision With a DisposableCircumcision Suture Device and a Discussion onthe Mechanism of Bleeding With the DisposableCircumcision Suture Device. Sexual Medicine.2021;9(2): 100288. https://doi.org/10.1016/j.esxm.2020.100288.

  22. Callegari M, Muncey W, Kim T, Rhodes S,Woo L, Hannick J. Where to draw the line?Understanding preferences in mucosal collarlength after circumcision: A crowdsourcedsurvey from the U.S. general population.Canadian Urological Association Journal =Journal De l’Association Des Urologues DuCanada. 2022;16(9): E473–E478. https://doi.org/10.5489/cuaj.7691.




2020     |     www.medigraphic.com