Abstract：Objective: To compare the clinical effects of Shang Ring, sleeve and conventional circumcisions in the treatment of redundant prepuce and phimosis. Methods: We reviewed the clinical data of 759 patients with redundant prepuce or phimosis treated from January 2007 to Decembe 2016. We documented operation time, intraoperative blood loss, intraoperative visual analogue scores, visual analogue scores 4-6 h, 24 h and 7 days postoperation, surgeons' satisfaction, incision healing time, degrees of preputial edema, postoperative complications, patients' satisfaction with penile appearance and compared them among the three groups. Results: Shang Ring circumcision significantly reduced the operation time and intraoperative blood loss as compared with conventional and sleeve circumcisions (P<0.05). The surgeons' satisfaction of Shang Ring and sleeve groups was higher than conventional group (P<0.05). The intraoperative and 4-6-h postoperative visual analogue score in Shang Ring group was significantly lower than that in other two groups (P<0.05), and the 7-day postoperative visual analogue score in Shang Ring group was significantly higher than that in other two groups (P<0.05). The 24-h postoperative visual analogue score in conventional group was higher than that in other two groups. The postoperative incision healing time was (18.3±2.8) d in the conventional circumcision group, (11.8±2.7) d in the sleeve circumcision group and (14.2±3.4) d in the Shang Ring circumcision group (P<0.05). As for the degree of preputial edema, sleeve circumcision showed similar effects to conventional circumcision but significantly better than Shang Ring circumcision (P<0.05). The 30-day postoperative IIEF-5 score in sleeve and Shang Ring circumcision groups was significantly higher than that in conventional group (P<0.05). Conclusions: Each of the three circumcision methods has its own advantages and disadvantages. The treatment decision should be individualized and based on a comprehensive consideration of each patient.
何存盛, 马国斌, 雷振伟. 商环包皮环切术、袖套式包皮环切术及传统包皮环切术临床应用对比分析[J]. 微创泌尿外科杂志, 2018, 7(3): 212-216.
He Cunsheng, Ma Guobin, Lei Zhenwei. A comparative study of Shang Ring, sleeve and conventional circumcisions for redundant prepuce and phimosis. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2018, 7(3): 212-216.
[1] Auvert B, Sobngwi-Tambekou J, Cutler EA, et al.Effect of male circumcision on the prevalence of High-Risk human papillomavirus in young men: results of a randomized controlled trial conducted in orange farm, South Africa. J Infect Dis, 2009,199(1):14-19. [2] Tobian AA, Serwadda D, Quinn TC, et al.Male circumcision for the prevention of HSV-2 and HPV infections and syphilis. N Engl J Med, 2009,360(13):1298-1309. [3] Wang Z, Feng T, Lau JT, et al.Acceptability of voluntary medical male circumcision (VMMC) among male sexually transmitted diseases patients (MSTDP) in China. PLoS One, 2016,11(2):e0149801. [4] Fink KS, Carson CC, Devellis RF.Adult circumcision outcomes study: effect on erectile function, penile sensitivity, sexual activity and satisfaction. J Urol, 2002,167(5):2113-2116. [5] 严广斌. 视觉模拟评分法.中华关节外科杂志(电子版),2014,8(2):273. [6] 邵绍丰,程斌,刘耀,等.包皮环切3种术式的临床观察.中华男科学杂志,2016,22(8):764-767. [7] 陈斌,卢永宁,韩银发,等.IIEF-5在血管性勃起功能障碍诊断中的应用.中华男科学杂志,2007,13(2):118-121. [8] 贲昆龙,徐建春,陆林,等.男性包皮环切是艾滋病预防和生殖健康的一种"外科疫苗".中华男科学杂志,2009,15(5):395-402. [9] Williams BG, Lloyd-Smith JO, Gouws EA, et al.The potential impact of male circumcision on HIV in sub-Saharan Africa. PLoS Med, 2006,3(7):1032-1040. [10] 李钢,洪宝发,张旭,等.包皮环切术的临床应用探讨(附1000例报告).临床泌尿外科杂志,2009,24(5):356-357. [11] Zhu YP, Jia ZW, Dai B, et al.Relationship between circumcision and human papillomavirus infection: a systematic review and meta-analysis. Asian J Androl, 2017,19(1):125-131. [12] 王荣,陈伟军,史文华,等.3 种包皮环切术的临床疗效分析.中华男科学杂志,2013,19(4):332-336. [13] 陈少安,刘川,胡自力,等.第三军医大学学报,2011,33(2):193-195. [14] 程跃,严泽军,苏新军.中国商环包皮环切术与传统包皮环切术的临床对比研究.中华泌尿外科杂志,2011,32(5):333-335. [15] Krill AJ, Palmer LS, Palmer JS.Complications of circumcision. Sci World J, 2011,11(3):2458-2468. [16] 李兴华,郑少斌.应用商环治疗儿童包皮过长和包茎的体会.中华男科学杂志,2011,17(6):542-545. [17] Peng YF, Cheng Y, Wang GY, et al.Clinical application of a new device for minimally invasive circumcision. Asian J Androl, 2008,10(3):447-454. [18] 吕年青,李石华,David Sokal.中国商环(Shang Ring)男性包皮环切技术临床应用研究进展.中华男科学杂志,2011,17(3):195-202. [19] 曹赟杰,何小舟,宋广来,等.新式包皮环切缝合器临床效果观察.中华临床医师杂志(电子版),2013,7(14):6526-6529. [20] Kanyago S, Riding DM, Mutakooha E, et al.Shang ring versus Forceps-Guided adult male circumcision: a randomized, controlled effectiveness study in southwestern Uganda. J Acquir Immune Defic Syndr, 2013,64(2):130-133. [21] Pan F, Pan L, Zhang A, et al.Circumcision with a novel disposable device in Chinese children: a randomized controlled trial. Int J Urol, 2013, 20(2): 220-226. [22] 黄桂填,韩宝泉,景玉兰.包皮环切术对性功能的影响.中国性科学,2009,18(2):28-29. [23] 冯世伟,丁全明,王刚,等.包皮环切术的临床应用分析.中国美容医学,2012,21(12):306-307. [24] O'Hara K, O'Hara J.The effect of male circumcision on the sexual enjoyment of the female partner. BJU Int, 1994,83(Suppl 1):51-52. [25] 任双全. 包皮环切术对包茎患者术后性生活满意度的影响.中国性科学,2013,22(9):19-21.
