Prospective Comparative Study of Adult Circumcision with Circular Stapler Versus Dorsal Slit Technique

Abstract

Background: Male circumcision is one of the most commonly performed surgical procedures worldwide and is undertaken for medical, hygienic, and cultural reasons. Conventional circumcision techniques such as the dorsal slit method are effective but may be associated with longer operative time, increased intraoperative blood loss, postoperative pain, and variable cosmetic outcomes. Recently, device-assisted techniques such as circular stapler circumcision have been introduced to improve surgical efficiency and patient outcomes. The present study was conducted to prospectively compare the safety, effectiveness, and postoperative outcomes of circular stapler circumcision with the conventional dorsal slit technique in adult male patients.
Methods: This prospective comparative study was conducted at tertiary care center over a period of 12 months. A total of 196 adult male patients undergoing elective circumcision were included and equally divided into two groups: Group 1 (Stapler technique, n = 98) and Group 2 (Dorsal slit technique, n = 98). Demographic characteristics, indications for circumcision, operative time, intraoperative blood loss, postoperative pain scores, wound healing duration, complications, cosmetic outcome, patient satisfaction, duration of hospital stay, and return to normal activities were recorded and analyzed. Statistical analysis was performed using SPSS software, and differences between groups were assessed using appropriate statistical tests with p < 0.05 considered statistically significant.
Results: The mean operative time was significantly shorter in the group 1(8.42 ± 1.96 minutes) compared with the group 2 (21.38 ± 3.74 minutes, p < 0.001). Intraoperative blood loss was also significantly lower in the group 1 (3.12 ± 1.04 ml) than in the group 2 (12.86 ± 3.48 ml, p < 0.001). Postoperative pain scores at 6, 24, and 48 hours were significantly lower in the group 1 (p < 0.001). Wound healing occurred faster in the group 1 (12.48 ± 2.16 days) compared with the group 2 (17.92 ± 3.84 days, p < 0.001). Postoperative complications were observed in 11.2% of patients in the group 1 and 26.5% in the group 2 (p = 0.018). Cosmetic outcomes and patient satisfaction were higher in the group 1, and the duration of hospital stay was significantly shorter (1.84 ± 0.62 vs 3.12 ± 1.08 days, p < 0.001).
Conclusion: The findings of the present study demonstrate that circular stapler circumcision offers several advantages over the conventional dorsal slit technique. The stapler method significantly reduces operative time and intraoperative blood loss while providing better postoperative comfort, faster wound healing, improved cosmetic outcomes, and higher patient satisfaction.