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Circumcision: Which is the most suitable surgical technique for yours?

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sabaycare
Soarawee Weerasopone, MD

Andrologist
Royal Phnom Penh hospital, Kingdom of Cambodia

A bunch literatures showing that about 30% of male population had been circumcised throughout the world. This topic is going to mention of which surgical techniques will gaining or presenting the best postoperatively outcomes and which one should be skipped or which one should be undergoing the circumcision procedure.

In term of postoperative outcomes, there are two major aspects that patients always concerned about. Firstly, is a medical concerned for like the bleeding, hematoma or a rarely risk of penile losing complication. Secondly, is a cosmetic concerned – beautiful circumcision penis always make sense of one-belonging feels more confident, right?

Surgical techniques

  1. Forceps-guided method of circumcision (Based on WHO recommendation)
Forceps Guided
Forceps-guided method (Ref from WHO 2009 on Male circumcision)

Simple step-by-step procedure, which can be learned by surgeons and surgical assistants who are new to surgery. Be able to get it done at Clinic with a limited resources.

Pros – Just only a simple surgical skill required, no Electrocauterization application needed.

Cons – May encounter bleeding complication, compromising in cosmetic outcome.

  1. Dorsal slit method of circumcision (Based on WHO recommendation)
Dorsal Slit
Dorsal Slit method (Ref from WHO 2009 on Male circumcision)

This technique required better in surgical skills than the #1 technique. This technique is widely used all over the world.

Pros – Better in term of cosmetic outcomes if compare to the forceps-guided method.

Cons – Take risk of the over-excision penile skin, required better surgical skill in that.

  1. Sleeve resection method of circumcision (Based on WHO recommendation)
Sleeve
Sleeve method (Ref from WHO 2009 on Male circumcision)

“Sleeve” is one part of the clothing which is made in garments factory. It’s the part of the arm’s cover up. You can imagine the Sleeve-like a penile skin that we want to fold up or remove, and the arm is like a core of penis. We just remove the sleeve from the arm. Required the most surgical skills which is suitable in hospital rather than in a clinic setting.  Electrocauterization is needed in this technique.

Sleeve like
Sleeve technique make operation lookalike remove the sleeve from the arm.

Pros – Best in term of cosmetic outcomes, being well – controlled of the bleeding.

Cons – Required the most surgical skills with assistants, take more time to get it done

  1. Disposable circumcision stapler
Disposable Circumcision Stapler
Disposable Circumcision Stapler

New technique which is need of a single-use disposable circumcision device that was developed by Chinese company. It is claimed that the strength points is on the shorter operative times, less blood loss and fewer postoperative complication.

Pros – Least operative time, less surgical blood loss, simple surgical skills required.

Cons – Highly selective patient for example – not allow to do stuff that make the infection-related causing, thicken preputial skin must be aware, mostly patients need to be removed surgical stapler after surgery and cost more on the operative disposable devices.

There just a few examples of widely approved surgical techniques in circumcision operation. For further information, you can discuss with your trusted urologist next to your place.

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