1. Adult circumcision with a Shang ring is a quick procedure.
In Shang ring circumcision, wound healing takes longer than traditional circumcision in adults. In a report published in the Journal of Urology 2012, a circumcision with a Shang ring versus conventional circumcision showed wound healing time in the circumcision with a Shang ring was longer.
Another report, Urology 2015, reported circumcision with a Shang ring versus conventional circumcision. Eight trials involving 3314 patients were included. Compared with traditional circumcision, Shang circumcision is associated with shorter surgical time, higher patient satisfaction with penile looks, lower operative pain, less operative blood loss, lower risks, and lower wound bleeding post-operatively. Shang circumcision appears safer and more practical than circumcision with stitches for male patients.
One long-term study showed a scar width of 3.7+/—1.6 mm (Clinical Medical Journal 2014). Healing showed a significant wound gap after removing the Shang ring, and this wound heals by secondary intention, scaring in some cases. No medical study stated how long adult patients feel pain after the Shang ring comes off.
Dr Khan has performed three revision circumcisions with glue after Shang ring circumcision and treated one wound dehiscence. Glue circumcision provides excellent cosmetic results with less pain and less complication rate. Patients suffered pain due to secondary healing of gapped wounds for three months after Shang ring circumcision in some patients. This required further studies to address this issue in Shang ring circumcision.
2. Adult male circumcision with a circular stapler (ZSR) versus conventional circumcision
Researchers studied the safety and efficacy of a male circumcision technique using a circular stapler. They divided 879 adult males into two groups: 441 underwent stapler circumcision, and 438 had traditional circumcision.
The circumcision with the stapler experienced lower operative time and blood loss. Additionally, they reported less pain during and after the procedure and had a lower complication rate (2.7% vs. 7.8%). However, treatment expenses for stapler circumcision were significantly higher, with most patients (388/441, 88.0%) needing the removal of a residual staple at the circumcision site.
This study demonstrates that stapler circumcision is efficient and safe, although further improvements are needed (Brazilian Journal of Medical and Biological Research (2015) 48: 577-582).
Studies evaluated the safety and efficacy of the disposable circumcision suture device (DCSD) compared to conventional circumcision (CC) for treating redundant prepuce and phimosis. Nine trials involving 1,898 cases were included. In comparison to the CC group, the stapler group demonstrated a shorter operative time, reduced wound healing duration, less intraoperative blood loss, improved cosmetic appearance of the penis, lower intraoperative pain scores, reduced 24-hour postoperative pain scores, a lower incidence of infection, decreased incision oedema, and fewer risks overall. No significant differences were observed between traditional and stapler circumcision regarding the incidences of wound disruptions or haematoma. The findings from these multiple studies suggest that circumcision with staplers is safer and more effective than traditional methods. (Asian Journal of Andrology (2017) 19, 362–367)
Benefits of Circumcision with CircCurer or ZSR Stapler
Circumcision with the CircCurer stapler is quick, offering several advantages over conventional stitching methods. Patients who undergo stapler circumcision experience shorter surgical durations, greater satisfaction with the aesthetic appearance of the penis, reduced operative pain, minimal blood loss during the procedure, and decreased postoperative wound bleeding. However, it is important to note that wound healing may take longer than with traditional circumcision methods in adults, and some patients may need to return for stapler removal. We offer stapler circumcision at our clinic.
3. Circumcision with Glue or Stitches
Traditionally, circumcision wounds are closed with absorbable sutures. In this study, tissue glue (iso-amyl 2-cyanoacrylate) was compared with traditional circumcision using stitches. The results indicated that significantly less time was consumed in the glue group. The researchers also assessed cosmetic outcomes, time taken, and the incidence of infection in both groups.
The Circumcision with tissue glue demonstrated reduced wound inflammation, bleeding, and haematoma rates and was cosmetically superior to circumcisions with sutures. The mean time for circumcision using tissue glue was 14.2 minutes, compared to 24.4 minutes with sutures, a highly significant difference. However, no reduction in post-operative pain was observed when glue was used during the circumcision.
In conclusion, this study indicated that using tissue glue, compared to sutures, offers the following advantages: 1. Cosmetically superior; 2. Less time-consuming. (Indian J Urol. 2011 Oct-Dec; 27(4): 475–478)
Furthermore, based on medical literature and online photos, our results with glue circumcision were superior to those of all other methods. Many patients’ feedback supports these findings.