Research Article
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The Relationship Between Preoperative Examination and High Phimosis Complication in Thermocautery Assisted Circumcision in İnfancy

Year 2023, , 563 - 571, 29.10.2023
https://doi.org/10.19127/mbsjohs.1258505

Abstract

Objective: To this study, we presented our experience with thermocautery assisted guillotine/clamp (TAG) method circumcisions on infant age and to share high rate of penile adhesions/phimosis complications that we found at the end of study.
Methods: A retrospective review between July 2020 and October 2022, 80 patients under the age of 1 who were circumcised by a single surgeon using the thermocautery assisted guillotine/clamp method, under the local anesthesia were included in the study (Thermo-Med TM 802B device; Thermo Medikal, Adana, Turkey).
Results: 80 patients were divided into 2 groups. Group 1 was 0-6 months old, group 2 was 6-12 months old. According to the weight percentile in group 1, 44.4% of the patients were above 75. percentile (p), in group 2, 34% of the patient were 25-50.p. In the preoperative evaluations, the presence of pubic fatty tissue was found in 24% of the patients in group 1 and 30% in group 2. Early complications occurred in 7 patients. Late complications were seen in 22 patients (27,5%). The presence of excess penile tissue was observed in 12 of them.
Conclusion: The TAG method is cheap, fast operation time and has a very good bleeding control. However, its use in infant group affects complication rates due to infant anatomical features. In the decision of circumcision in infant age, if there is a pubic fatty tissue in the preoperative examination, the high probability of complications should be taken into account when choosing the TAG method

Project Number

1

References

  • World Health Organization; Joint United Nations Programme on HIV/AIDS. Neonatal and child male circumcision: a global review. 2010. Accessed January 22,2020.https://www.who.inti/hiv/pub/malecircumcision/neonatal_child_MC_UNAIDS.pdf.
  • Hung YC, Chang DC, Westfal ML, Marks IH, Masiakos PT, Kelleher CM. A longitudinal population analysis of cumulative risks of circumcision. J.Surg Res. 2019;233:111-117.
  • Pieretti RV, Goldstein AM, Pieretti-Vanmarcke R. Late complications of newborn circumcision: a common and avoidable problem. Pediatr Surg Int. 2010 May;26(5):515-8. doi: 10.1007/s00383-010-2566-9. Epub 2010 Feb 14. PMID: 20155423.
  • Ponsky LE, Ross JH, Knipper N, Kay R. Penile adhesions after neonatal circumcision. J Urol. 2000 Aug;164(2):495-6. PMID: 10893633.
  • Karaman, M. I., Zulfikar, B., Caskurlu, T., & Ergenekon, E. (2004). Circumcision in hemophilia: A cost-effective method using a novel device. Journal of Pediatric Surgery, 39, 1562–1564. https://doi.org/10.1016/j.jpedsurg.2004.06.025
  • Lane JE, O'brien EM, Kent DE. Optimization of thermocautery in excisional dermatologic surgery. Dermatol Surg. 2006 May;32(5):669-75. doi: 10.1111/j.1524-4725.2006.32139.x. PMID: 16706762
  • Tuncer AA, Bozkurt MF, Bayraktaroğlu A, Koca HB, Doğan I, Çetinkursun S, Embleton DB. Examination of histopathological changes of scalpel, monopolar, bipolar, and thermocautery applications in rat experimental circumcision model. Am J Transl Res. 2017 May 15;9(5):2306-2313. PMID: 28559981; PMCID: PMC5446513.
  • Zambrano Navia M, Jacobson DL, Balmert LC, Rosoklija I, Holl JL, Davis MM, Johnson EK. State-Level Public Insurance Coverage and Neonatal Circumcision Rates. Pediatrics. 2020 Nov;146(5):e20201475. doi: 10.1542/peds.2020-1475. Epub 2020 Oct 14. PMID: 33055226.
  • El-Asmar KM, Abdel-Kader HM, El-Shafei EA, Ashraf I. Comparison between the bone cutter with thermal cautery, Gomco, and Plastibell for circumcision in neonates and infants: a prospective randomized trial. Egypt J Surg 2017;36:27e32.
  • Tuncer AA, Deger M. Incidence of Complications Following Thermocautery-assisted Circumcisions. Urol J. 2018 Nov 17;15(6):359-364. doi: 10.22037/uj.v0i0.4296. PMID: 29616499.
  • Storm DW, Baxter C, Koff SA, Alpert S. The relationship between obesity and complications after neonatal circumcision. J Urol. 2011 Oct;186(4 Suppl):1638-41. doi: 10.1016/j.juro.2011.04.016. PMID: 21862040
  • Omole F, Smith W, Carter-Wicker K. Newborn Circumcision Techniques. Am Fam Physician. 2020 Jun 1;101(11):680-685. PMID: 32463643.
  • Akyüz O, Tatar Z. Is it safe to use a thermocautery device for circumcision? Examination of the histopathological changes emerging after thermocautery-assisted circumcisions. Andrologia. 2021 Apr;53(3):e13968. doi: 10.1111/and.13968. Epub 2021 Jan 9. PMID: 33421180.
  • Schmelzle HR, Fusch C. Body fat in neonates and young infants: validation of skinfold thickness versus dual-energy X-ray absorptiometry. Am J Clin Nutr. 2002 Nov;76(5):1096-100. doi: 10.1093/ajcn/76.5.1096. PMID: 12399284.
  • Karaman MI, Zulfikar B, Caskurlu T, Ergenekon E. Circumcision in hemophilia: a cost-effective method using a novel device. J Pediatr Surg. 2004 Oct;39(10):1562-4. doi: 10.1016/j.jpedsurg.2004.06.025. PMID: 15486905.
Year 2023, , 563 - 571, 29.10.2023
https://doi.org/10.19127/mbsjohs.1258505

Abstract

Supporting Institution

Yok

Project Number

1

References

  • World Health Organization; Joint United Nations Programme on HIV/AIDS. Neonatal and child male circumcision: a global review. 2010. Accessed January 22,2020.https://www.who.inti/hiv/pub/malecircumcision/neonatal_child_MC_UNAIDS.pdf.
  • Hung YC, Chang DC, Westfal ML, Marks IH, Masiakos PT, Kelleher CM. A longitudinal population analysis of cumulative risks of circumcision. J.Surg Res. 2019;233:111-117.
  • Pieretti RV, Goldstein AM, Pieretti-Vanmarcke R. Late complications of newborn circumcision: a common and avoidable problem. Pediatr Surg Int. 2010 May;26(5):515-8. doi: 10.1007/s00383-010-2566-9. Epub 2010 Feb 14. PMID: 20155423.
  • Ponsky LE, Ross JH, Knipper N, Kay R. Penile adhesions after neonatal circumcision. J Urol. 2000 Aug;164(2):495-6. PMID: 10893633.
  • Karaman, M. I., Zulfikar, B., Caskurlu, T., & Ergenekon, E. (2004). Circumcision in hemophilia: A cost-effective method using a novel device. Journal of Pediatric Surgery, 39, 1562–1564. https://doi.org/10.1016/j.jpedsurg.2004.06.025
  • Lane JE, O'brien EM, Kent DE. Optimization of thermocautery in excisional dermatologic surgery. Dermatol Surg. 2006 May;32(5):669-75. doi: 10.1111/j.1524-4725.2006.32139.x. PMID: 16706762
  • Tuncer AA, Bozkurt MF, Bayraktaroğlu A, Koca HB, Doğan I, Çetinkursun S, Embleton DB. Examination of histopathological changes of scalpel, monopolar, bipolar, and thermocautery applications in rat experimental circumcision model. Am J Transl Res. 2017 May 15;9(5):2306-2313. PMID: 28559981; PMCID: PMC5446513.
  • Zambrano Navia M, Jacobson DL, Balmert LC, Rosoklija I, Holl JL, Davis MM, Johnson EK. State-Level Public Insurance Coverage and Neonatal Circumcision Rates. Pediatrics. 2020 Nov;146(5):e20201475. doi: 10.1542/peds.2020-1475. Epub 2020 Oct 14. PMID: 33055226.
  • El-Asmar KM, Abdel-Kader HM, El-Shafei EA, Ashraf I. Comparison between the bone cutter with thermal cautery, Gomco, and Plastibell for circumcision in neonates and infants: a prospective randomized trial. Egypt J Surg 2017;36:27e32.
  • Tuncer AA, Deger M. Incidence of Complications Following Thermocautery-assisted Circumcisions. Urol J. 2018 Nov 17;15(6):359-364. doi: 10.22037/uj.v0i0.4296. PMID: 29616499.
  • Storm DW, Baxter C, Koff SA, Alpert S. The relationship between obesity and complications after neonatal circumcision. J Urol. 2011 Oct;186(4 Suppl):1638-41. doi: 10.1016/j.juro.2011.04.016. PMID: 21862040
  • Omole F, Smith W, Carter-Wicker K. Newborn Circumcision Techniques. Am Fam Physician. 2020 Jun 1;101(11):680-685. PMID: 32463643.
  • Akyüz O, Tatar Z. Is it safe to use a thermocautery device for circumcision? Examination of the histopathological changes emerging after thermocautery-assisted circumcisions. Andrologia. 2021 Apr;53(3):e13968. doi: 10.1111/and.13968. Epub 2021 Jan 9. PMID: 33421180.
  • Schmelzle HR, Fusch C. Body fat in neonates and young infants: validation of skinfold thickness versus dual-energy X-ray absorptiometry. Am J Clin Nutr. 2002 Nov;76(5):1096-100. doi: 10.1093/ajcn/76.5.1096. PMID: 12399284.
  • Karaman MI, Zulfikar B, Caskurlu T, Ergenekon E. Circumcision in hemophilia: a cost-effective method using a novel device. J Pediatr Surg. 2004 Oct;39(10):1562-4. doi: 10.1016/j.jpedsurg.2004.06.025. PMID: 15486905.
There are 15 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Research articles
Authors

Aybegum Kalyoncu Ayçenk 0000-0002-9853-3803

Project Number 1
Early Pub Date October 27, 2023
Publication Date October 29, 2023
Published in Issue Year 2023

Cite

Vancouver Kalyoncu Ayçenk A. The Relationship Between Preoperative Examination and High Phimosis Complication in Thermocautery Assisted Circumcision in İnfancy. Mid Blac Sea J Health Sci. 2023;9(4):563-71.

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