Techniques of male circumcision

Abstract

Male circumcision is a controversial subject in surgical practice. There are, however, clear surgical indications of this procedure. The American Academy of Pediatrics (AAP) recommends newborn male circumcision for its preventive and public health benefits that has been shown to outweigh the risks of newborn male circumcision. Many surgical techniques have been reported. The present review discusses some of these techniques with their merits and drawbacks. This is an attempt to inform the reader on surgical aspects of male circumcision aiding in making appropriate choice of a technique to offer patients. Pubmed search was done with the keywords: Circumcision, technique, complications, and history. Relevant articles on techniques of circumcision were selected for the review. Various methods of circumcision including several devices are in use for male circumcision. These methods can be grouped into three: Shield and clamp, dorsal slit, and excision. The device methods appear favored in the pediatric circumcision while the risk of complications increases with increasing age of the patient at surgery.

Circumcision in the paediatric patient: A review of indications, technique and complications

“…The procedure is commonly performed under general or local anaesthesia, although no anaesthesia may be administered in cultural or religious circumcisions. Local anaesthesia can be achieved in a number of ways, including a penile ring block or a penile dorsal nerve block . The continued practice of neonatal circumcision, in which sucrose alone is often used, is controversial.…”

“…Local anaesthesia can be achieved in a number of ways, including a penile ring block or a penile dorsal nerve block. 85 The continued practice of neonatal circumcision, in which sucrose alone is often used, is controversial. Sucrose has been shown to be an effective analgesic for infants undergoing painful procedures, such as heel lance, venepuncture and intramuscular injection.…”

Circumventing the Urologist: A Case of Poorly Executed Self-Circumcision

“…The indications for circumcision in the adult male include the preventable conditions listed above as well as excessive foreskin redundancy, frenular tears and patient preference due to social, religious or personal motivations as alluded to above (5). Recently, there has been increased interest in the procedure after three large randomized-controlled trials showed evidence that circumcision reduces transmission of HIV between 51% and 60% (6,7,8). Not surprisingly, these studies have lead to the advent of new technology aimed at simplifying the manner in which circumcisions can be performed, particularly in the form of clamps (9).…”

Male Circumcision: Unending Debate

“…Circumcision can be performed through one of three main methods: dorsal slit, shield-clamp (Mogen clamp, Plastibell®, Gomco clamp, Zhenxi ring, Tara clamp, Smart clamp, Shang Ring®, and Prepex® device), and surgery (Sleeve resection) or through a combination of all three (11). Apart from these, it is also possible to circumcise with hand tools, which use the cutting and burning process simultaneously, called circumcision thermocauter.…”