title: [Outward versus inward placement in Shang Ring circumcision for phimosis and redundant prepuce in adult men: analysis of 527 cases].
abstract: OBJECTIVE
  To observe the clinical effects of two different circumcision procedures with the Shang Ring and compare their advantages and disadvantages.
  
  
  METHODS
  A total of 527 adult males with phimosis or redundant prepuce underwent Shang Ring circumcision by conventional outward replacement (n = 254) and inward placement (n = 273), respectively. We observed the in-ring nocturnal pain, complications, ring-removal pain, degree of edema, recovery time, and patients' satisfaction after surgery, and compared them between the two groups.
  
  
  RESULTS
  Compared with the conventional outward placement (5.9%) of the Shang Ring, the inward placement method showed the advantages of mild in-ring nocturnal pain, a low complication rate, significantly reduced ring-removal pain, and mild edema, but exhibited longer healing time.
  
  
  CONCLUSIONS
  In Shang Ring circumcision for phimosis and redundant prepuce in adult males, each of the outward and inward placement methods has advantages and disadvantages of its own, but the latter is more advantageous and feasible.
authors.forename: Sheng-Tao
authors.initials: ST
authors.lastname: Xie
authors.forename: Guang-Yu
authors.initials: GY
authors.lastname: Chen
authors.forename: Qiao-Hong
authors.initials: QH
authors.lastname: Wei
authors.forename: Xiao-Tong
authors.initials: XT
authors.lastname: Liu
authors.forename: Lin
authors.initials: L
authors.lastname: Jiao
authors.forename: Yao
authors.initials: Y
authors.lastname: Tang
mesh_terms: D000328:Adult; D002944:Circumcision, Male / Q000009:adverse effects / Q000295:instrumentation*; D004487:Edema / Q000209:etiology; D052816:Foreskin / Q000002:abnormalities / Q000601:surgery; D006801:Humans; D008297:Male; D010149:Postoperative Pain; D017060:Patient Satisfaction; D010409:Penile Diseases / Q000209:etiology; D010413:Penis / Q000002:abnormalities / Q000601:surgery*; D010688:Phimosis / Q000601:surgery*; D019736:Prostheses and Implants; D014945:Wound Healing