title: Application of a novel disposable suture device in circumcision: a prospective non-randomized controlled study.
abstract: OBJECTIVE
  To compare the surgical effects and postoperative complications and patient experience of two circumcision methods (novel disposable suture device and conventional suture approach) in Chinese excess foreskin or phimosis patients performed in our Andrology centre in a prospective non-randomized controlled study.
  
  
  METHODS
  A total of 520 cases of excess foreskin and 62 phimosis patients that underwent circumcision between June 2014 and June 2015 in a single center using novel disposable device (n = 295; mean age 30.4 years, range 18-44 years) and conventional suture approach (n = 287; mean age 28.6 years, range 16-41 years) were documented. The main surgical outcomes (surgical time, intraoperative blood loss, incision healing time) and postoperative complications and patient experience (postoperative pain score, satisfaction rate of postoperative penile cosmetic appearance, recovery duration) were collected and analyzed. A multivariate logistic regression with likelihood ratio test was also used to observe the possible determinants of edema occurrence postoperatively.
  
  
  RESULTS
  The novel disposable suture device group had shorter operation time, lower pain score and rapid recovery and a higher satisfaction rate of penile cosmetic appearance when compared to the conventional circumcision group. Besides, the incidence of complications (hematoma and incision bleeding and infection) was significantly lower in the novel disposable suture device group. A multivariate logistic regression with likelihood ratio test revealed that phimosis was the significant predictor of edema occurrence postoperatively (Chi square of likelihood ratio = 9.88, df = 1, p = 0.025).
  
  
  CONCLUSIONS
  Circumcision using this novel disposable suture device is associated with short operative time, rapid recovery, less pain experience, less complications (hematoma and incision bleeding and infection) and high satisfaction rate of penile appearance. This new approach should be of value for future application. Phimosis patients should be notified that they had a great possibility to develop edema postoperatively regardless of the surgical options.
authors.affiliation: Department of Andrology, Drum Tower Hospital, Affiliated to School of Medicine, Nanjing University, #321 Zhong Shan Road, Nanjing, 210008, China.
authors.forename: Zheng
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: Department of Andrology, Drum Tower Hospital, Affiliated to School of Medicine, Nanjing University, #321 Zhong Shan Road, Nanjing, 210008, China.
authors.forename: Baibing
authors.initials: B
authors.lastname: Yang
authors.affiliation: Department of Andrology, Drum Tower Hospital, Affiliated to School of Medicine, Nanjing University, #321 Zhong Shan Road, Nanjing, 210008, China.
authors.forename: Wen
authors.initials: W
authors.lastname: Yu
authors.affiliation: Department of Andrology, Drum Tower Hospital, Affiliated to School of Medicine, Nanjing University, #321 Zhong Shan Road, Nanjing, 210008, China.
authors.forename: Youfeng
authors.initials: Y
authors.lastname: Han
authors.affiliation: Department of Andrology, Drum Tower Hospital, Affiliated to School of Medicine, Nanjing University, #321 Zhong Shan Road, Nanjing, 210008, China.
authors.forename: Zhipeng
authors.initials: Z
authors.lastname: Xu
authors.affiliation: Department of Andrology, Drum Tower Hospital, Affiliated to School of Medicine, Nanjing University, #321 Zhong Shan Road, Nanjing, 210008, China.
authors.forename: Hai
authors.initials: H
authors.lastname: Chen
authors.affiliation: Department of Andrology, Drum Tower Hospital, Affiliated to School of Medicine, Nanjing University, #321 Zhong Shan Road, Nanjing, 210008, China.
authors.forename: Yun
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of Andrology, Drum Tower Hospital, Affiliated to School of Medicine, Nanjing University, #321 Zhong Shan Road, Nanjing, 210008, China. 13913957628@163.com.
authors.forename: Yutian
authors.initials: Y
authors.lastname: Dai
mesh_terms: D000293:Adolescent; D000328:Adult; D002944:Circumcision, Male / Q000379:methods*; D004209:Disposable Equipment; D004867:Equipment Design; D052816:Foreskin / Q000601:surgery*; D006801:Humans; D008297:Male; D061646:Operative Time; D017060:Patient Satisfaction; D010688:Phimosis / Q000601:surgery*; D011446:Prospective Studies; D013536:Suture Techniques / Q000295:instrumentation*; D013537:Sutures; D016896:Treatment Outcome; D014945:Wound Healing; D055815:Young Adult
keywords: Circumcision; Edema; Excess foreskin; Novel disposable suture device; Phimosis