ISSN: 1735-1308
May-June 2022
Vol. 19 No. 03 (2022)
Circumcision with Thermocautery after Local Anesthesia in Males: A Retrospective Single-center Study with 1821 Patients
Urology Journal,
Vol. 19 No. 03 (2022),
,
Page 221-227
https://doi.org/10.22037/uj.v19i.6748
Abstract
Purpose: This study aimed to examine the short and long-term complications of thermocautery-assisted circumcisions with local anesthesia done in a sterile environment in operating room conditions, accompanied by literature.
Materials and Methods: The participants who consecutively underwent thermocautery-assisted circumcision with local anesthesia from June 2018 to May 2019 included in the study. They were one month-17 years old, same ethnic origin, in same location. The age groups were compared in terms of complications.
Results: The participant age and surgical duration means were 4.89 ± 2.08 (30 days-17 years) years old and 7.484 ± 1.524 (5-20 minutes) minutes, respectively. Complications were observed in fifty-three participants or 2.9% of the whole observation set. The participants under intervals of one six months and over 6 years of age had significantly lowered complication rates when compared to the other participants, and this comparison was statistically significant (P = 0.001).
Conclusion: The study results demonstrated that circumcision with thermocautery after local anesthesia viable, reliable, and effective method. It can be assumed that circumcisions in males especially may be effective in 1-6 months, and over 6 years of age. Parents choose this method because it is more appropriate and eliminates the risk of general anesthesia.
Keywords:
- circumcision, children, local anesthesia, complication, thermocautery
How to Cite
Uysal, M., & Şanlı, A. (2022). Circumcision with Thermocautery after Local Anesthesia in Males: A Retrospective Single-center Study with 1821 Patients. Urology Journal, 19(03), 221-227. https://doi.org/10.22037/uj.v19i.6748
References
References
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2. Lerman S.E., Liao J.C.,(2001). Neonatal circumcision. Pediatr Clin North, 48(6), 1539-57.
3. Holman J.R., Lewis E.L., R., (1995). Neonatal circumcision techniques. Am Fam Physician , 52,511-518.
4. Niku S.D., Stock JA., Kaplan G.W. , (1995). Neonatal Circumcision. Urologic Clinics of North America 22(1), 57-65.
5. Rizvi SAH, Naqvi SAA, Hussain M., Hasan A.S., (1999). Religious circumcision: a Muslim view. BJU Int, 83 (suppl.1), 13-16
6. Prabhakaran S., Ljuhar D., Coleman R., Nataraja R.M., (2018). Circumcision in the paediatric patient: a review of indications, technique and complications. J Paediatr Child Health, 54, 1299-1307.
7. Krill A.J., Palmer L.S., , Palmer J.S., (2011). Complications of circumcision. Scientific World Journal, 11, 2458-68.
8. Weiss H.A., Larke N., Halperin D., Schenker I., (2010). Complications of circumcision in male neonates, infants and children: A systematic review. BMC Urol., 10, 2.
9. Morris B.J., Wamai R.G., Henebeng E.B., Tobian A.A., Klausner J.D., Banerjee J, et al. (2016). Estimation of countryspecific and global prevalence of male circumcision. Popul Health Metr, 14, 4.
10.American Academy of Pediatrics (2012). Circumcision policy statement. Pediatrics. 130,585-86.
11. Thorup J., Thorup S.C., Ifaoui I.B., (2013). Complication rate after circumcision in a paediatric surgical setting should not be neglected. Dan Med J., 60(8), A4681
12. Tahmaz M.L., Erduran I.N., Dayanç M.,(2004). Güncel Çocuk Ürolojisi. Ankara: Atlas Kitapçılık, 281-294.
13.Male circumcision (2012).Task force on circumcision. Pediatrics September 2012, 130 (3), e756-e785; doi:10.1542/peds. 2012-1990
14. Clavien P.A., Barkun J., de Oliveira M.L., et al, (2009). The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg. ,250,187-196.
15. Introcaso C.E., Xu F., Kilmarx P.H., Zaidi A., Markowitz L.E.,(2013). Prevalence of circumcision among men and boys aged 14 to 59 years in the United States, National Health and nutrition examination surveys 2005-2010. Sexually Transmitted Diseases., 40 (7),521-525
16. Morris BJ, Kennedy SE, Wodak AD, Mindel A, Golovsky D, Schrieber L, et al., (2017). Early infant male circumcision: Systematic review, risk-benefit analysis, and progress in policy. World Journal of Clinical Pediatrics, 6(1),89-102
17.El Bcheraoui C, Zhang X, Cooper CS, Rose CE, Kilmarx PH, Chen RT.,(2014). Rates of adverse events associated with male circumcision in U.S. medical settings, 2001 to 2010. JAMA Pediatrics, 168(7), 625-634
18. Krill AJ, Palmer LS, Palmer JS.,(2014). Complications of circumcision. Scientific World Journal, 11, 2458-68.
19. Eke N.,(2000). Major surgical complications from minor urological procedures. J Natl Med Assoc. 2000, 92, 196-9.
20. Özen MA, Gündoğdu G, Taşdemir M, Eroğlu E.,(2017). Complication of newborn circumcision: meatal stenosis or meatal web? J Pediatr Urol. doi:10.1016/j.jpurol.2017.05.007.
21. Saeedi P, Ahmadnia H, Akhavan Rezayat A.,(2017). Evaluation of the effect of meatal stenosis on the urinary tract by using ultrasonography. Urol J., 14, 3071-4.
22.Lane JE, O'brien EM, Kent DE.,(2006). Optimization of thermocautery in excisional dermatologic surgery. Dermatol Surg., 32,669-75.
23. Arslan D, Kalkan M, Yazgan H, Unuvar U, Şahin C.,(2013). Collective circumcision performed in Sudan: evaluation in terms of early complications and alternative practice. Urology, 81, 864-8.
24. Abdel Hay S. ,(2009). The use of thermal cautery for male circumcision. JKAU Med Sci. , 16, 89-93.
25. Tuncer A.A., Bozkurt M.F., Bayraktaroğlu A., et al.,(2017). Examination of histopathological changes of scalpel, monopolar, bipolar, and thermocautery applications in rat experimental circumcision model. Am J Transl Res., 9, 2306-13.
26. Karaman M.I., Zulfikar B., Caskurlu T., Ergenekon E., (2004). Circumcision in hemophilia: a cost-effective method using a novel device. J Pediatr Surg., 39, 1562-4.
27. Kazeem M.M., Mehdi A.Z., Golrasteh K.Z., Behzad F.Z.,(2010). Comparative evaluation of two techniques of hemostasis in neonatal circumcision using the Plastibell® device. J Pediatr Urol. , 6, 258-60.
28. Mihssin N., Moorthy K., Houghton W.J.,(1999). Retention of urine: an unusual complication of the Plastibell device. BJU Int., 84, 747.
29.Saracoglu M., Öztürk H., Zengin T., Kerman H.S.,(2014). Comparison of thermal cautery-assisted circumcision with the conventional technique. Human Andrology, 4,34-37.
30. Moosa F.A., Khan F.W., Rao M.H.,(2010). Comparison of complications of circumcision by ‘Plastibell device technique’ in male neonates and infants. J Pak Med Assoc., 60, 664-7.
31. Jimoh B.M., Odunayo I.S., Chinwe I., Akinfolarin O.O., Oluwafemi A., Olusanmi E.J.,(2016). Plastibell circumcision of 2,276 male infants: a multi-centre study. Pan Afr Med J., 23-35.
32. Reynolds R.D.,(1996). Use of the Mogen clamp for neonatal circumcision. Am Fam Physician, 54,177-82.
33.Young M.R., Bailey R.C.., Odoyo-June E, et al.,(2012). Safety of over twelve hundred infant male circumcisions using the Mogen clamp in Kenya. PLoS One., 7, 47395.
34. Senel F.M., Demirelli M., Oztek S.,(2010). Minimally invasive circumcision with a novel plastic clamp technique: a review of 7,500 cases. Pediatr Surg Int., 26, 739-45.
35. Abdulwahab-Ahmed A., Mungadi I.A., (2013).Techniques of male circumcision. J Surg Tech Case Rep., 5, 1-7.
36. Awori Q.D., Lee R.K., Li P.S., et al.,(2017). Use of the Shang ring circumcision device in boys below 18 years old in Kenya: results from a pilot study. J Int AIDS Soc. , 20, 1-8.
37. Huang C., Song P., Xu C., Wang R., Wei L., Zhao X.,(2017). Comparative efficacy and safety of different circumcisions for patients with redundant prepuce or phimosis: a network meta-analysis. Int J Surg. ,43, 17-25.
38. Amir M., Raja M.H., Niaz W.A., (2000). Neonatal circumcision with Gomco clamp--a hospital-based retrospective study of 1000 cases. J Pak Med Assoc., 50, 224-7.
39. Özen M.A., Gündoğdu G., Taşdemir M., Eroğlu E.,(2017). Complication of newborn circumcision: meatal stenosis or meatal web? J Pediatr Urol. doi: 10.1016/j.jpurol.2017.05.007
40. Buwembo D.R., Musoke R., Kigozi G., et al.,(2012). Evaluation of the safety and efficiency of the dorsal slit and sleeve methods of male circumcision provided by physicians and clinical officers in Rakai, Uganda. BJU Int., 109, 104-8.
41. Uzun G., Ozdemir Y., Eroglu M., Mutluoglu M.,(2012). Electrocautery-induced gangrene of the glans penis in a child following circumcision. BMJ Case Rep.
42. Shen J., Shi J, Gao J, et al.,(2017). A comparative study on the clinical efficacy of two different disposable circumcision suture devices in adult males. Urol J., 14, 5013-7.
43. Cathcart P., Nuttall M., Meulen J.V,D.,, et al (2003). Trends in paediatric circumcision and its complications in England between 1997 and 2003. Br J Surg , 93, 885–890.
44. G. Micha, E. Samanta, D. Damigos , A. Petridis, V. Mavreas , S. Livanios.,(2009). Impact of an Anesthesia Discharge Scoring System on Postoperative Monitoring after Circumcision in Children: A Randomized TrialEur J Pediatr Surg.,19(5), 293-6
45. Ersöz G,Çatlı D.,(2018). Turk J Anaesthesiol Reanim. The Effects of Lidocaine with Epinephrine on Bupivacaine-Induced Cardiotoxicity, ; 46(6), 447-52
46. Ngcobo S., Wolvaardt J.E., Bac M., et al., (2018). The quality of voluntary medical male circumcision done by mid-level workers in Tshwane District,South Africa: a retrospective analysis. PLoS One. 13, e0190795.
47. Balkan E., Kılıç N.,(2005). Sünnet ve komplikasyonlar. Güncel Pediatri, 2, 22-23.
48. Tuncer A.A., Erten E.E.A., (2017). Examination of short and long term complications of
thermocautery, plastic clamping, and surgical circumcision techniques. Pak J Med Sci
33, 1418–1423.
1. Rudolph C., Rudolph A., Lister G., First L., Gershon A.,(2016 ). McGraw-Hill Companies, Incorporated,188,978.
2. Lerman S.E., Liao J.C.,(2001). Neonatal circumcision. Pediatr Clin North, 48(6), 1539-57.
3. Holman J.R., Lewis E.L., R., (1995). Neonatal circumcision techniques. Am Fam Physician , 52,511-518.
4. Niku S.D., Stock JA., Kaplan G.W. , (1995). Neonatal Circumcision. Urologic Clinics of North America 22(1), 57-65.
5. Rizvi SAH, Naqvi SAA, Hussain M., Hasan A.S., (1999). Religious circumcision: a Muslim view. BJU Int, 83 (suppl.1), 13-16
6. Prabhakaran S., Ljuhar D., Coleman R., Nataraja R.M., (2018). Circumcision in the paediatric patient: a review of indications, technique and complications. J Paediatr Child Health, 54, 1299-1307.
7. Krill A.J., Palmer L.S., , Palmer J.S., (2011). Complications of circumcision. Scientific World Journal, 11, 2458-68.
8. Weiss H.A., Larke N., Halperin D., Schenker I., (2010). Complications of circumcision in male neonates, infants and children: A systematic review. BMC Urol., 10, 2.
9. Morris B.J., Wamai R.G., Henebeng E.B., Tobian A.A., Klausner J.D., Banerjee J, et al. (2016). Estimation of countryspecific and global prevalence of male circumcision. Popul Health Metr, 14, 4.
10.American Academy of Pediatrics (2012). Circumcision policy statement. Pediatrics. 130,585-86.
11. Thorup J., Thorup S.C., Ifaoui I.B., (2013). Complication rate after circumcision in a paediatric surgical setting should not be neglected. Dan Med J., 60(8), A4681
12. Tahmaz M.L., Erduran I.N., Dayanç M.,(2004). Güncel Çocuk Ürolojisi. Ankara: Atlas Kitapçılık, 281-294.
13.Male circumcision (2012).Task force on circumcision. Pediatrics September 2012, 130 (3), e756-e785; doi:10.1542/peds. 2012-1990
14. Clavien P.A., Barkun J., de Oliveira M.L., et al, (2009). The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg. ,250,187-196.
15. Introcaso C.E., Xu F., Kilmarx P.H., Zaidi A., Markowitz L.E.,(2013). Prevalence of circumcision among men and boys aged 14 to 59 years in the United States, National Health and nutrition examination surveys 2005-2010. Sexually Transmitted Diseases., 40 (7),521-525
16. Morris BJ, Kennedy SE, Wodak AD, Mindel A, Golovsky D, Schrieber L, et al., (2017). Early infant male circumcision: Systematic review, risk-benefit analysis, and progress in policy. World Journal of Clinical Pediatrics, 6(1),89-102
17.El Bcheraoui C, Zhang X, Cooper CS, Rose CE, Kilmarx PH, Chen RT.,(2014). Rates of adverse events associated with male circumcision in U.S. medical settings, 2001 to 2010. JAMA Pediatrics, 168(7), 625-634
18. Krill AJ, Palmer LS, Palmer JS.,(2014). Complications of circumcision. Scientific World Journal, 11, 2458-68.
19. Eke N.,(2000). Major surgical complications from minor urological procedures. J Natl Med Assoc. 2000, 92, 196-9.
20. Özen MA, Gündoğdu G, Taşdemir M, Eroğlu E.,(2017). Complication of newborn circumcision: meatal stenosis or meatal web? J Pediatr Urol. doi:10.1016/j.jpurol.2017.05.007.
21. Saeedi P, Ahmadnia H, Akhavan Rezayat A.,(2017). Evaluation of the effect of meatal stenosis on the urinary tract by using ultrasonography. Urol J., 14, 3071-4.
22.Lane JE, O'brien EM, Kent DE.,(2006). Optimization of thermocautery in excisional dermatologic surgery. Dermatol Surg., 32,669-75.
23. Arslan D, Kalkan M, Yazgan H, Unuvar U, Şahin C.,(2013). Collective circumcision performed in Sudan: evaluation in terms of early complications and alternative practice. Urology, 81, 864-8.
24. Abdel Hay S. ,(2009). The use of thermal cautery for male circumcision. JKAU Med Sci. , 16, 89-93.
25. Tuncer A.A., Bozkurt M.F., Bayraktaroğlu A., et al.,(2017). Examination of histopathological changes of scalpel, monopolar, bipolar, and thermocautery applications in rat experimental circumcision model. Am J Transl Res., 9, 2306-13.
26. Karaman M.I., Zulfikar B., Caskurlu T., Ergenekon E., (2004). Circumcision in hemophilia: a cost-effective method using a novel device. J Pediatr Surg., 39, 1562-4.
27. Kazeem M.M., Mehdi A.Z., Golrasteh K.Z., Behzad F.Z.,(2010). Comparative evaluation of two techniques of hemostasis in neonatal circumcision using the Plastibell® device. J Pediatr Urol. , 6, 258-60.
28. Mihssin N., Moorthy K., Houghton W.J.,(1999). Retention of urine: an unusual complication of the Plastibell device. BJU Int., 84, 747.
29.Saracoglu M., Öztürk H., Zengin T., Kerman H.S.,(2014). Comparison of thermal cautery-assisted circumcision with the conventional technique. Human Andrology, 4,34-37.
30. Moosa F.A., Khan F.W., Rao M.H.,(2010). Comparison of complications of circumcision by ‘Plastibell device technique’ in male neonates and infants. J Pak Med Assoc., 60, 664-7.
31. Jimoh B.M., Odunayo I.S., Chinwe I., Akinfolarin O.O., Oluwafemi A., Olusanmi E.J.,(2016). Plastibell circumcision of 2,276 male infants: a multi-centre study. Pan Afr Med J., 23-35.
32. Reynolds R.D.,(1996). Use of the Mogen clamp for neonatal circumcision. Am Fam Physician, 54,177-82.
33.Young M.R., Bailey R.C.., Odoyo-June E, et al.,(2012). Safety of over twelve hundred infant male circumcisions using the Mogen clamp in Kenya. PLoS One., 7, 47395.
34. Senel F.M., Demirelli M., Oztek S.,(2010). Minimally invasive circumcision with a novel plastic clamp technique: a review of 7,500 cases. Pediatr Surg Int., 26, 739-45.
35. Abdulwahab-Ahmed A., Mungadi I.A., (2013).Techniques of male circumcision. J Surg Tech Case Rep., 5, 1-7.
36. Awori Q.D., Lee R.K., Li P.S., et al.,(2017). Use of the Shang ring circumcision device in boys below 18 years old in Kenya: results from a pilot study. J Int AIDS Soc. , 20, 1-8.
37. Huang C., Song P., Xu C., Wang R., Wei L., Zhao X.,(2017). Comparative efficacy and safety of different circumcisions for patients with redundant prepuce or phimosis: a network meta-analysis. Int J Surg. ,43, 17-25.
38. Amir M., Raja M.H., Niaz W.A., (2000). Neonatal circumcision with Gomco clamp--a hospital-based retrospective study of 1000 cases. J Pak Med Assoc., 50, 224-7.
39. Özen M.A., Gündoğdu G., Taşdemir M., Eroğlu E.,(2017). Complication of newborn circumcision: meatal stenosis or meatal web? J Pediatr Urol. doi: 10.1016/j.jpurol.2017.05.007
40. Buwembo D.R., Musoke R., Kigozi G., et al.,(2012). Evaluation of the safety and efficiency of the dorsal slit and sleeve methods of male circumcision provided by physicians and clinical officers in Rakai, Uganda. BJU Int., 109, 104-8.
41. Uzun G., Ozdemir Y., Eroglu M., Mutluoglu M.,(2012). Electrocautery-induced gangrene of the glans penis in a child following circumcision. BMJ Case Rep.
42. Shen J., Shi J, Gao J, et al.,(2017). A comparative study on the clinical efficacy of two different disposable circumcision suture devices in adult males. Urol J., 14, 5013-7.
43. Cathcart P., Nuttall M., Meulen J.V,D.,, et al (2003). Trends in paediatric circumcision and its complications in England between 1997 and 2003. Br J Surg , 93, 885–890.
44. G. Micha, E. Samanta, D. Damigos , A. Petridis, V. Mavreas , S. Livanios.,(2009). Impact of an Anesthesia Discharge Scoring System on Postoperative Monitoring after Circumcision in Children: A Randomized TrialEur J Pediatr Surg.,19(5), 293-6
45. Ersöz G,Çatlı D.,(2018). Turk J Anaesthesiol Reanim. The Effects of Lidocaine with Epinephrine on Bupivacaine-Induced Cardiotoxicity, ; 46(6), 447-52
46. Ngcobo S., Wolvaardt J.E., Bac M., et al., (2018). The quality of voluntary medical male circumcision done by mid-level workers in Tshwane District,South Africa: a retrospective analysis. PLoS One. 13, e0190795.
47. Balkan E., Kılıç N.,(2005). Sünnet ve komplikasyonlar. Güncel Pediatri, 2, 22-23.
48. Tuncer A.A., Erten E.E.A., (2017). Examination of short and long term complications of
thermocautery, plastic clamping, and surgical circumcision techniques. Pak J Med Sci
33, 1418–1423.
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