Concealed penis is usually found in children, which affects the patients both physiologically and psychologically. Some of the patients are wrongly treated by circumcision, which may bring about serious consequences to the sexual life of the patients in their adulthood. In the recent years, this disease has been receiving more and more attention from both doctors and parents. However, controversies remain as to its classification, pathogenesis, pathology, and treatment. This paper focuses on the understanding and advances in the studies of concealed penis.
Child ; Circumcision, Male ; adverse effects ; psychology ; Humans ; Male ; Penis ; abnormalities ; surgery ; Sexual Behavior

OBJECTIVETo evaluate the erectile function of adults after circumcision.

METHODSNinty-five patients were investigated on erectile function by questionnaire before and after circumcision, respectively.

RESULTSEighteen patients suffered from mild erectile dysfunction before circumcision, and 28 suffered from mild or moderate erectile dysfunction after circumcision(P = 0.001). Adult circumcision appeared to have resulted in weakened erectile confidence in 33 cases(P = 0.04), difficult insertion in 41 cases(P = 0.03), prolonged intercourse in 31 cases(P = 0.04) and improved satisfaction in 34 cases(P = 0.04).

CONCLUSIONSAdult circumcision has certain effect on erectile function, to which more importance should be attached.

Adult ; Circumcision, Male ; adverse effects ; Erectile Dysfunction ; etiology ; Humans ; Male ; Middle Aged ; Penile Erection

OBJECTIVETo compare the effect and safety of the no-flip method versus the external method in Shang Ring circumcision.

METHODSWe searched relevant randomized controlled trials published in China and abroad comparing the no-flip method and external method of Shang Ring circumcision. Based on the Cochrane Handbook for systematic review, two reviewers independently eval- uated the quality of the included studies and abstracted relevant data, followed by a meta-analysis using the statistical software Review Manager 5.1.0.

RESULTSTotally 7 studies with 1 200 cases were included. Compared with the external method, the no-flip method was associated with a lower total rate of complications (RR = 0.40, 95% CI: 0.18, 0.87, P = 0.02), a lower incidence of postop- erative edema (RR = 0.28, 95% CI: 0.09, 0.81, P = 0.02), and a lower 24 h postoperative pain score (MD = -0.35, 95% CI: -0.55, -0.14, P < 0.001).

CONCLUSIONThe no-flip method of Shang Ring circumcision was superior to the external method for its advantages of fewer complications, lower incidence of postoperative edema, and mild postoperative pain. However, our findings need further support by more high-quality randomized controlled trials.

China ; Circumcision, Male ; adverse effects ; instrumentation ; methods ; Edema ; epidemiology ; Humans ; Male ; Pain Measurement ; Pain, Postoperative ; epidemiology ; Randomized Controlled Trials as Topic

Priapism is rare on clinical condition with complicated pathogenesis which is very difficult to cure. The paper reported a case of a long-time priapism, complicated local skin necrosis, which was caused by circumcision. After the failure of routine therapy, we treated the patient with traditional Chinese therapy, such as TCM herbs combined with bone scraping and depletion therapy, and achieved the satisfactory effect.
Adult ; Circumcision, Male ; adverse effects ; Combined Modality Therapy ; Erectile Dysfunction ; etiology ; therapy ; Humans ; Male ; Medicine, Chinese Traditional ; Necrosis

OBJECTIVETo investigate the effect of standardized male circumcision with Shang Ring in reducing postoperative complications.

METHODSWe performed standardized male circumcision with Shang Ring for 351 males aged 4-58 (mean 31) years, 46 with phimosis and 305 with redundant prepuce, and observed the complications, including postoperative bleeding, infection, edema, and wound dehiscence.

RESULTSThe main complications included infection (5 cases, 1.42%), mild edema (9 cases, 2.56%), moderate edema (5 cases, 1.42%), and wound dehiscence (6 cases, 1.71%), but no postoperative bleeding was observed.

CONCLUSIONUsing the standard protocol of circumcision with Shang Ring, well-trained male circumcision providers can significantly reduce postoperative complications and enhance the patient's satisfaction. Normalized training of the circumcision providers is essential for the popularization of standardized male circumcision with Shang Ring.

Adolescent ; Adult ; Child ; Child, Preschool ; Circumcision, Male ; adverse effects ; methods ; standards ; Humans ; Male ; Middle Aged ; Postoperative Complications ; prevention & control

A 33-year-old male receiving dorsal penile nerve block (DPNB) for circumcision exhibited a postoperative ischemic change over the glans penis. The event occurred nearly 24 hours after the procedure. The patient was treated with intravenous pentoxifyllin and hyperbaric oxygenation. Total reverse of the ischemia was observed. The complications associated with circumcision and DPNB were reviewed and discussed.
Adult ; Circumcision, Male ; adverse effects ; Humans ; Infection ; etiology ; pathology ; Ischemia ; etiology ; pathology ; Male ; Nerve Block ; adverse effects ; Penis ; blood supply ; pathology ; Pentoxifylline ; pharmacology ; Vasodilator Agents ; pharmacology

OBJECTIVETo improve the methods and reduce the complications of circumcision with a disposable suture device.

METHODSThis study included 325 male patients aged 14-65 (mean 28.9) years, treated for redundant prepuce or phimosis by modified (n = 201) or conventional circumcision with a disposable suture device (n = 124). We compared the incidence of complications and the patients' satisfaction between the two surgical methods.

RESULTSCompared with conventional circumcision, the modified method showed a significantly lower incidence of postoperative bleeding (14.52% vs 2.49% , P < 0.05) and a lower rate of second surgery for penile hematoma (4.03% vs 0.50%, P < 0.05). The patients' satisfaction was markedly higher with the modified method (91.94%) than with conventional circumcision (97.51%) (P < 0.05).

CONCLUSIONModified circumcision with the disposable suture device can significantly reduce the incidence of postoperative bleeding and penile hematoma and therefore deserves wide clinical application.

Adolescent ; Adult ; Aged ; Circumcision, Male ; adverse effects ; instrumentation ; Disposable Equipment ; Humans ; Incidence ; Male ; Middle Aged ; Patient Satisfaction ; Penis ; surgery ; Phimosis ; surgery ; Postoperative Complications ; epidemiology ; Suture Techniques ; instrumentation ; Sutures

Penile amputation is a rare catastrophe and a serious complication of circumcision. Reconstruction of the glans penis may be indicated following amputation. Our report discusses a novel technique for reconfiguration of an amputated glans penis 1 year after a complicated circumcision. A 2-year-old male infant presented to us with glans penis amputation that had occurred during circumcision 1 year previously. The parents complained of severe meatal stenosis with disfigurement of the penis. Penis length was 3 cm. Complete penile degloving was performed. The distal part of the remaining penis was prepared by removing fibrous tissue. A buccal mucosal graft was applied to the distal part of the penis associated with meatotomy. The use of a buccal mucosal graft is a successful and simple procedure with acceptable cosmetic and functional results for late reconfiguration of the glans penis after amputation when penile size is suitable.
Amputation, Traumatic/*surgery ; Child, Preschool ; Circumcision, Male/adverse effects ; Humans ; Male ; Mouth Mucosa/*transplantation ; Penis/*injuries/*surgery ; Reconstructive Surgical Procedures/*methods

OBJECTIVETo compare the clinical effects of the circumcision stapler, circumcision cerclage, and traditional circumcision in the treatment of phimosis and redundant prepuce.

METHODSUsing the circumcision stapler (group A), foreskin cerclage (group B), and traditional circumcision (group C), we treated 276 patients with phimosis or redundant prepuce. We made comparisons among the three groups in the operation time, intraoperative blood loss, intraoperative and 24-hour postoperative pain scores, and incidence of postoperative complications. Results: The operation time, intraoperative blood loss, and intraoperative pain score were (6.52 ± 2.45) min, (1.93 ± 0.82) ml, and 1.37 ± 0.68 in group A and (7.24 ± 1.86) min, (1.51 ± 0.72) ml, and 1.20 ± 0.79 in group B, all significantly lower than (28. 36 ± 4.22) min, (9.52 ± 3.29) ml, and 3.06 ± 0.75 in group C (P <0.05). The 24-hour postoperative pain score was remarkably higher in group B than in A and C (3. 18 ± 0. 82 vs 1. 85 ± 0. 63 and 1. 82 ± 0. 75, P <0. 05). The incidence rate of postoperative complications was markedly lower in group A than in B (5. 43% vs 14. 13%, P < 0.05), but with no significant differences between either A and C or B and C (P >0.05).

CONCLUSIONThe circumcision stapler, with its advantages of simple operation, minimal invasiveness, fewer complications, and better cosmetic result, deserves a wider clinical application.

Blood Loss, Surgical ; Circumcision, Male ; adverse effects ; instrumentation ; methods ; Foreskin ; Humans ; Incidence ; Male ; Pain Measurement ; Pain, Postoperative ; diagnosis ; Penis ; abnormalities ; Phimosis ; therapy ; Postoperative Complications ; Postoperative Period

OBJECTIVETo observe the clinical effect and safety of circumcision stapler in the treatment of phimosis and redundant prepuce.

METHODSWe treated 120 patients with redundant prepuce or phimosis using circumcision stapler and another 60 by conventional dorsal-incision circumcision. We observed intraoperative blood loss, operation time, postoperative pain, wound healing time, cosmetic appearance of the penis, and postoperative complications and compared them between the two groups of patients.

RESULTSStapler circumcision showed obvious advantages over the conventional method in intraoperative blood loss ([2. 3 ± 1. 3] vs [15.6 ± 2.9] ml), operation time ([7.1 ± 1.4] vs [22.6 ± 4.6] min), wound healing time ([12.0 ± 2.9] as [16.3 ± 3. 1] d), postoperative pain score (1. 9 ± 1. 3 vs 5. 2 ± 1. 7), incision edema, and cosmetic appearance of the penis (all P <0. 05). Besides, stapler circumcision exempted the patients from stitch-removal pain. However, the incidence rate of postoperative local ecchymosis was significantly higher in the circumcision stapler group than in the conventional circumcision group (20. 8% vs 8. 3% , P <0. 05).

CONCLUSIONCircumcision stapler, with its advantages of easier manipulation, shorter operation time, better cosmetic penile appearance, less pain, and fewer complications, is superior to conventional circumcision in the treatment of phimosis and redundant prepuce.

Blood Loss, Surgical ; Circumcision, Male ; instrumentation ; methods ; Ecchymosis ; etiology ; Humans ; Male ; Pain, Postoperative ; Penis ; abnormalities ; Phimosis ; therapy ; Postoperative Complications ; Postoperative Period ; Surgical Staplers ; adverse effects ; Wound Healing