Preservation of Frenular Artery During Circumcision

Background: Circumcision is a widely performed surgical procedure. Though it is a simple operation, oftentimes a number of complications are encountered. Among them post-circumcision pain and bleeding are of paramount concern. These may cause apprehension in the parents as well as in patients. Surgical procedure of circumcision should, therefore, be pain-free and devoid of complication as much as possible. Methods: In this prospective randomized doubnle blind observational study, we had compared two commonly practiced technique of circumcision and evaluated the outcomes in regard to post circumcision pain and complications, and overall cosmesis. The study was carried out in 100 boys randomly allocated in two groups from July 2016 through June 2017. Result: The results revealed that the modified sleeve method in which the frenular artery of penis was preserved was associated with significantly less post circumcision pain and fewer complications. In addition, boys who underwent modified sleeve method exhibited better overall cosmesis. Conclusion: It could be reasonably inferred that preservation of frenular artery during circumcision reduces post circumcision pain and complications and provides better cosmesis. Birdem Med J 2018; 8(2): 145-150

[1]  T. Akkaya,et al.  Effect of two surgical circumcision procedures on postoperative pain: A prospective, randomized, double-blind study. , 2015, Journal of pediatric urology.

[2]  D. Teitelbaum,et al.  Newborn circumcision outcomes: Are parents satisfied with the results? , 2014, Pediatric Surgery International.

[3]  G. Buonocore,et al.  Analgesia for infants’ circumcision , 2013, Italian Journal of Pediatrics.

[4]  J. de Bessa,et al.  Prospective randomized trial comparing dissection with Plastibell® circumcision. , 2010, Journal of pediatric urology.

[5]  Moslemi Mohammad Kazem,et al.  Comparative evaluation of two techniques of hemostasis in neonatal circumcision using the Plastibell device. , 2010, Journal of pediatric urology.

[6]  H. Weiss,et al.  Complications of circumcision in male neonates, infants and children: a systematic review , 2010, BMC urology.

[7]  A. Goldstein,et al.  Late complications of newborn circumcision: a common and avoidable problem , 2010, Pediatric Surgery International.

[8]  H. Rode,et al.  Circumcision complications associated with the Plastibell device. , 2007, South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde.

[9]  M Emberton,et al.  Trends in paediatric circumcision and its complications in England between 1997 and 2003 , 2006, The British journal of surgery.

[10]  F. Ziade,et al.  Addition of clonidine and fentanyl: comparison between three different regional anesthetic techniques in circumcision , 2005, Paediatric anaesthesia.

[11]  S. Dollberg,et al.  Bupivacaine versus lidocaine analgesia for neonatal circumcision , 2005, BMC pediatrics.

[12]  Wilkinson Gb.  Circumcision: one of the oldest known surgical procedures. , 1997 .

[13]  N. Cohen,et al.  Determinants of Decision Making for Circumcision , 1996, Cambridge Quarterly of Healthcare Ethics.

[14]  F. Hinman.  The blood supply to preputial island flaps. , 1991, The Journal of urology.

[15]  Abdelmonem Awad Hegazy.  Male circumcision: review and authors perspective , 2012 .

[16]  S. Abram.  Even routine painful procedures can be harmful for the newborn , 2010 .

[17]  T. Wiswell.  Circumcision circumspection. , 1997, The New England journal of medicine.

[18]  P. Mouriquand,et al.  Clinical presentation and pathophysiology of meatal stenosis following circumcision. , 1995, British journal of urology.

[19]  J. Schoch,et al.  [Postoperative analgesia for circumcision in children]. , 1990, Agressologie: revue internationale de physio-biologie et de pharmacologie appliquees aux effets de l'agression.

[20]  M. Vater,et al.  Caudal or dorsal nerve block? A comparison of two local anaesthetic techniques for postoperative analgesia following day case circumcision. , 1985, Acta anaesthesiologica Scandinavica.