Adult male circumcision performed with plastic clamp technique in Turkey: results and long-term effects on sexual function.

PURPOSE: To evaluate the long-term results of adult circumcisions performed by plastic clamp technique as well as the effects on sexual function. MATERIALS AND METHODS: A total of 186 adult males with the mean age of 21.2 ± 2.8 years who presented to our clinic for circumcision between February 2007 and January 2010 were included in the study. Safety and acceptability of circumcision with plastic clamp technique as well as its effects on sexual functions were analyzed with a mean follow-up period of 30.4 ± 14.2 months (range, 12 to 52 months). RESULTS: The mean duration of circumcision and removal of the clamp were 3.1 ± 1.1 minutes and 16 ± 7 seconds, respectively. The total complication rate was 2.15%. Wound dehiscence (1.07%), infection (0.54%), and bleeding (0.54%) were the encountered complications. Complete wound healing was observed at a mean of 25.5 ± 4.6 days. We did not encounter any penile deformity or other long-term complications. Circumcision did not adversely affect the sexual drive or ejaculation based on the brief male sexual function inventory scores. Erectile function and overall satisfaction improved following circumcision. CONCLUSION: Circumcision performed by plastic clamp technique in adult males had a low early complication rate with no long-term complications and caused improvement in some of the sexual functions. We suggest the utilization of this technique as an easy and a safe way of circumcising adult males.

The safety profile and acceptability of a disposable male circumcision device in Kenyan men undergoing voluntary medical male circumcision.

PURPOSE: We established the safety and effectiveness as well as the acceptability of the Alisklamp® device for male circumcision among Kenyan men. MATERIALS AND METHODS: To qualify for this hospital based, prospective, interventional cohort study one needed to be an uncircumcised adult male who was HIV negative with no comorbid factors or genitourinary anomalies precluding circumcision. A total of 58 men were recruited from a population of 90. Outcome measures were the safety profile of Alisklamp and its efficiency and acceptability by participants. RESULTS: All 58 procedures were completed without device malfunction, hemorrhage or undesirable preputial excision. Mean ± SD procedure time was 2.43 ± 1.36 minutes and mean device removal time was 15.8 ± 7.4 seconds. There were 2 adverse events, including mild edema and superficial wound infection related to poor hygiene in 1 case each. All men resumed routine activity immediately after circumcision. Of the 58 participants 25.9% experienced mild nocturnal erectile pains that required no medication. During 6-week followup all men were satisfied with the procedure, tolerated the device well and would recommend it to a friend. CONCLUSIONS: Alisklamp has an excellent safety profile and excellent acceptability among men who undergo circumcision using the device. This technique is easy to teach and it would prove to be a handy device to scale up the rate of male circumcision. Based on these findings the device merits a comparative clinical trial.

Mass circumcision with a novel plastic clamp technique.

OBJECTIVE: To evaluate the safety and efficacy of mass circumcision performed using a plastic clamp. METHODS: A total of 2013 males, including infants, children, adolescents, and adults were circumcised during a 7-day period by using a plastic clamp technique. Complications were analyzed retrospectively in regard to 4 different age groups. Postcircumcision sexual function and satisfaction rates of the adult males were also surveyed. RESULTS: The mean duration of circumcision was 3.6±1.2 minutes. Twenty-six males who were lost to follow-up were excluded from the study. The total complication rate was found to be 2.47% among the remaining 1987 males, with a mean age of 7.8±2.5 years. The highest complication rate (2.93%) was encountered among the children<2 years age, which was because of the high rate of buried penis (0.98%) and excessive foreskin (0.98%) observed in this group. The complication rates of older children, adolescents, and adults were slightly lower than the children<2 years age, at 2.39%, 2.51%, and 2.40%, respectively. Excessive foreskin (0.7%) was the most common complication observed after mass circumcision. Bleeding (0.6%), infection (0.55%), wound dehiscence (0.25%), buried penis (0.25%), and urine retention (0.1%) were other encountered complications. The erectile function and sexual libido in adolescents and adults was not affected by circumcision and a 96% satisfaction rate was obtained. CONCLUSIONS: Mass circumcision performed by a plastic clamp technique was found to be a safe and time-saving method of circumcising a large number of males at any age.

Minimally invasive circumcision with a novel plastic clamp technique: a review of 7,500 cases.

PURPOSE: We aimed to analyze the outcome of circumcisions performed with a new minimally invasive circumcision device. METHODS: This is the first study, which reports the results of 7,500 children circumcised with minimally invasive technique utilizing a plastic clamp device (Ali's clamp) in our country. The results of this technique are compared to those of 5,700 children who underwent conventional circumcision. RESULTS: The most common complication encountered after minimally invasive circumcision technique was found to be buried penis (1.04%). The second complication observed was infection (0.6%), which was significantly lower than the conventional group (p < 0.001). The third complication in plastic clamp group was bleeding with a rate of 0.4%. Bleeding was found to be the most common complication seen after conventional circumcision (5%) and was significantly higher than that of the plastic clamp group (p < 0.001). Total number of complications seen after plastic clamp technique was 2% when compared with 10.4% complication rate occurred after conventional circumcision (p < 0.001). The mean duration of circumcision time with plastic clamp technique was 4.5 +/- 1.5 min whereas with conventional circumcision it was 23 +/- 4 min (p < 0.0001). CONCLUSION: Minimally invasive circumcision technique utilizing plastic clamp significantly reduced the complication rates. The cosmetic appearance after circumcisions performed with this technique was observed to be better than the conventional circumcisions. Due to reduced complications, as well as short duration and ease of application, the minimally invasive technique is suggested as the circumcision procedure of choice.