1. 宁波大学医学院附属宁波市第一医院泌尿中心，浙江 宁波 315010；
2. 皖南医学院弋矶山医院性医学科，安徽芜湖 241001；
3. 上海交通大学医学院附属仁济医院泌尿科，上海 200127；
4. 首都医科大学附属北京朝阳医院泌尿科，北京 100034；
5. 江苏省计划生育科学技术研究所，江苏 南京 210036；
6. Center for Male Reproductive Medicine and Microsurgery, Cornell Institute for Reproductive Medicine, Department of Urology, The New York Presbyterian Hospital, Weill Medical College of Cornell University, NewYork, NY 10065- 4870, USA;
7. Family Health International, Research Triangle Park, NC27709, USA)
Zhonghua Nan Ke Xue. 2009 Jul;15(7):584-92.
A recommendable standard protocol of adult male circumcision with the Chinese Shang Ring: outcomes of 328 cases in China.
[Article in Chinese]
Cheng Y, Peng YF, Liu YD, Tian L, Lü NQ, Su XJ, Yan ZJ, Hu JS, Lee R, Kim HH, Sokal DC, Li PS.
Department of Urology, The First Hospital of Ningbo, Ningbo University School of Medicine, Ningbo, Zhejiang 315010, China. email@example.com
OBJECTIVE: Standardization of and training in adult male circumcision can significantly reduce its complication rate. Currently no such program exists for its standardization and training, making it difficult to guarantee the quality of male circumcision services. We therefore established a standardized surgical protocol for adult male circumcision in China using the Shang Ring, and applied it to a clinical study examining the performance of the Shang Ring in adult male circumcision.
METHODS: A total of 328 adult men aged 18-58 (mean 27.8) years, 25 with phimosis and 303 with redundant prepuce, underwent circumcision with the Shang Ring, and evaluation of the operation time, pain scores (using the visual analog scale), postoperative complications, time for wound healing, and their satisfaction with the postoperative appearance.
RESULTS: The operation time was 4.7 +/- 1.3 minutes. The pain scores were 0. 2 +/- 0.6 during the surgery, 1.6 +/- 1.0 twenty hours postoperatively, 1.7 +/- 1.1 twenty hours prior to the ring removal, and 2.7 +/- 1.4 during the ring removal. Complications included infection in 2 (0.6%), bleeding in 2 (0.6%), and wound dehiscence in 2 (0.6%) of the patients. None of the patients with wound dehiscence required postoperative suturing and all were managed conservatively instead. Sixteen of the patients (4.9%) experienced penile edema. The time for complete wound healing after circumcision was 20.3 +/- 6.7 days. The rate of the patients'satisfaction was 99.7% (327/328).
CONCLUSION: The standard protocol of adult male circumcision with the Shang Ring has the advantages of short operation time, slight pain, low rate of complications, and high satisfaction and acceptance of the patients. Strict standardization of the surgical protocol can maximize its clinical advantages for adult male circumcision.