Mp43-18 How to Reduce Intractable Prepuce Edema and Frenulum Shortage Following Circumcision With a Disposable Circumcision Suture Device?

You have accessJournal of UrologySurgical Technology & Simulation: Instrumentation & Technology II (MP43)1 May 2024MP43-18 HOW TO REDUCE INTRACTABLE PREPUCE EDEMA AND FRENULUM SHORTAGE FOLLOWING CIRCUMCISION WITH A DISPOSABLE CIRCUMCISION SUTURE DEVICE? Chin-Heng Lu, Chao-Yu Hsu, Yen-Chuan Ou, and Min-Che Tung Chin-Heng LuChin-Heng Lu , Chao-Yu HsuChao-Yu Hsu , Yen-Chuan OuYen-Chuan Ou , and Min-Che TungMin-Che Tung View All Author Informationhttps://doi.org/10.1097/01.JU.0001008720.96896.83.18AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Conventional circumcision was time consuming. Recently, a disposable circumcision suture device (DCSD) was invented and became more and more common. The outcome of circumcision with DCSD is not so uniform and still need surgeon's skill and experience. Sometimes DCSD cannot fit the prepuce anatomical diversity during circumcision. Post circumcision prepuce edema and frenulum shortage were two of the most common complication. The purpose of our study is to analyze the relationship of device size and the duration of prepuce edema post DCSD and introduce the skill to prevent frenulum shortage. METHODS: Adult male patients with redundant prepuce and/or phimosis without diabetes mellitus were included in a clinical trial from January 2020 to February 2023. Parameters of age, hight, weight, BMI, penis diameter and diameter difference of penis and DCSD were analyzed. Circumcision with DCSD diameter 26, 30, 34mm patients were included. The "frenulum preserving stitch" (FPS) skill was used. Post circumcision persisted prepuce swelling at 7, 14,28,56,84 days was recorded. RESULTS: A total of 211 patients were recruited. The mean age was 34.1 years. Diameter difference of penis and DCSD was the significant risk factor for persisted prepuce swelling at 14,28,56,84 days in all patients (<0.001, <0.001, 0,003, and 0,004 respectively). In 26mm diameter DCSD patients, significant prepuce swelling was noted at 14,28,56,84 days (p=0.003, 0.034, 0.002 and 0.018 respectively). In 30mm diameter DCSD patients, significant prepuce swelling was noted at 14,28 days (p=0.004, 0.024 respectively). In 34mm diameter DCSD patients, significant prepuce swelling was noted at 14 days only (p=0.026). We further subdivided each groups according to diameter difference of penis and DCSD, almost all patient had prepuce swelling at 7 days and persisted prepuce swelling cases were in small diameter difference of penis and DCSD patients. There was no frenulum shortage after circumcision with FPS skill. CONCLUSIONS: Our results revealed that when the diameter of DCSD just fit or very close to the diameter of detumescent penis, chose larger size could prevent long-term prepuce edema. The technique of modified DCSD with PFS circumcision method was introduced step-by-step in this study. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e701 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Chin-Heng Lu More articles by this author Chao-Yu Hsu More articles by this author Yen-Chuan Ou More articles by this author Min-Che Tung More articles by this author Expand All Advertisement PDF downloadLoading ...