title: [Circumcision with no-flip Shang Ring technique for adult males: analysis of 168 cases].
abstract: OBJECTIVE
  To observe the clinical effects of the no-flip procedure with the Chinese Shang Ring when circumcising adult males with redundant prepuce or phimosis, and to discuss its advantages and disadvantages.
  
  
  METHODS
  Using the no-flip Shang Ring technique, we performed circumcision for 167 adult males aged 18 -72 (mean 27.8) years with redundant prepuce or phimosis, and analyzed the clinical data, including the operation time, postoperative complications, ring-removal time, and postoperative appearance of the penis.
  
  
  RESULTS
  Complete follow-up data of 94 cases (56.29%) were obtained. The mean operation time was (5.03 +/- 0.71) minutes and the average ring-removal time was (18.83 +/- 6.70) days. The primary postoperative complications were edema (35 cases [37.23%] at 2 weeks and 9 cases [9.57%] at 4 weeks), including 2 severe cases (2.13%), and infection (3 cases [3.19%]). The pain scores were 2.01 +/- 2.46 during the procedure and 4.52 +/- 2.53 at 24 hours postoperatively. Slipping of the outer ring occurred in 1 case, and delayed removal of the ring in 30 cases (31.91%).
  
  
  CONCLUSIONS
  Adult male circumcision with the no-flip Shang Ring technique is recommended for its short operation time, simple procedure, fewer postoperative complications, less pain, and better incision appearance.
authors.forename: Jun-Hao
authors.initials: JH
authors.lastname: Lei
authors.forename: Liang-Ren
authors.initials: LR
authors.lastname: Liu
authors.forename: Xiao
authors.initials: X
authors.lastname: Lü
authors.forename: Si-Hang
authors.initials: SH
authors.lastname: Cheng
authors.forename: Ying-Chun
authors.initials: YC
authors.lastname: Cai
authors.forename: Yong-Ji
authors.initials: YJ
authors.lastname: Chen
authors.forename: Qiang
authors.initials: Q
authors.lastname: Wei
authors.forename: Yu-Chun
authors.initials: YC
authors.lastname: Zhu
mesh_terms: D000328:Adult; D000368:Aged; D002944:Circumcision, Male / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D004487:Edema / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D010149:Postoperative Pain / Q000209:etiology; D010409:Penile Diseases / Q000209:etiology; D010413:Penis / Q000002:abnormalities / Q000601:surgery; D010688:Phimosis / Q000601:surgery*; D011183:Postoperative Complications; D011184:Postoperative Period; D019736:Prostheses and Implants; D055815:Young Adult