title: SmartClamp circumcision versus conventional dissection technique in terms of parental anxiety and outcomes: A prospective clinical study.
abstract: BACKGROUND
  We prospectively analyzed parental anxiety and outcomes of the SmartClamp circumcision and the classic surgical dissection technique.
  
  
  METHODS
  A total of 250 boys underwent circumcision between 2009 and 2012 at Kars State Hospital and Kafkas University Faculty of Medicine in Turkey. The initial 125 children were circumcised by conventional dissection method and the remaining children were operated on with a SmartClamp device. Children in both groups were compared in terms of bleeding, infection, penile edema, operative time, cosmetic result, length of the inner mucosal layer, and parental anxiety. We used a State-Trait Anxiety Inventory (STAI) form to gauge how the circumcision affected parental anxiety. This form was completed by parents on postoperative day 2.
  
  
  RESULTS
  There were no statistically significant differences among the 2 groups in terms of age, bleeding, infection, and cosmetic displeasure (p > 0.05). The STAI scores of the parents from the SmartClamp group were statistically higher than that of the other group (p < 0.001). Penile edema was more common in the SmartClamp group (p = 0.039). However, the mean operative time was statistically shorter (p < 0.001) and the inner mucosal length was significantly longer in the SmartClamp group (p < 0.001).
  
  
  CONCLUSIONS
  Circumcision with the SmartClamp device was faster. Cosmetic results and complication rates were similar. Unfortunately, this technique seemed to entail the disadvantages of longer mucosal length, penile edema, and higher parental anxiety. Urologists should keep these points in mind when choosing a technique.
authors.affiliation: Kafkas University Faculty of Medicine, Department of Urology, Kars, Turkey;
authors.forename: Mert Ali
authors.initials: MA
authors.lastname: Karadag
authors.affiliation: Kafkas University Faculty of Medicine, Department of Urology, Kars, Turkey;
authors.forename: Kursat
authors.initials: K
authors.lastname: Cecen
authors.affiliation: Kafkas University Faculty of Medicine, Department of Urology, Kars, Turkey;
authors.forename: Aslan
authors.initials: A
authors.lastname: Demir
authors.affiliation: Kafkas University Faculty of Medicine, Department of Psychiatry, Kars, Turkey;
authors.forename: Yuksel
authors.initials: Y
authors.lastname: Kivrak
authors.affiliation: Kafkas University Faculty of Medicine, Department of Urology, Kars, Turkey;
authors.forename: Murat
authors.initials: M
authors.lastname: Bagcioglu
authors.affiliation: Kafkas University Faculty of Medicine, Department of Urology, Kars, Turkey;
authors.forename: Ramazan
authors.initials: R
authors.lastname: Kocaaslan
authors.affiliation: Mustafa Kemal University Faculty of Medicine, Department of Psychiatry, Hatay, Turkey;
authors.forename: Mustafa
authors.initials: M
authors.lastname: Ari
authors.affiliation: Bilim University Faculty of Medicine, Department of Urology, Istanbul, Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Altunrende