Comparison of Intraoperative and Postoperative Outcomes of Sleeve and Dorsal Slit Technique of Circumcision: A Prospective Interventional Study

Introduction: Circumcision is the excision of the foreskin of the penis. Adult circumcision, although less prevalent, produces more discomfort and carries a fair share of complications if not performed meticulously. The dorsal slit technique and sleeve technique are the most followed techniques, the...

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Main Authors: N Snigdha, R Lakshmana, Das Debarath, Natarjan Soorya, A Pravindhas, M Malar Mannan
Format: Article
Language:English
Published: JCDR Research and Publications Private Limited 2025-01-01
Series:Journal of Clinical and Diagnostic Research
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Online Access:https://www.jcdr.net/articles/PDF/20550/74061_CE[Ra1]_F(SHU)_QC(SD_SHU)_PF1(AG_SL)_PFA_NC(IS)_PN(IS).pdf
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author N Snigdha
R Lakshmana
Das Debarath
Natarjan Soorya
A Pravindhas
M Malar Mannan
author_facet N Snigdha
R Lakshmana
Das Debarath
Natarjan Soorya
A Pravindhas
M Malar Mannan
author_sort N Snigdha
collection DOAJ
description Introduction: Circumcision is the excision of the foreskin of the penis. Adult circumcision, although less prevalent, produces more discomfort and carries a fair share of complications if not performed meticulously. The dorsal slit technique and sleeve technique are the most followed techniques, the dorsal slit being the conventional method. Aim: To compare the intraoperative and postoperative outcomes of the dorsal slit technique and sleeve technique of circumcision. Materials and Methods: A prospective interventional study was conducted at SRM Medical College Hospital and Research Centre, Chennai, Tamil Nadu, India from October 2022 to April 2024. Sixty patients diagnosed with phimosis, balanoposthitis, paraphimosis and patients who requested circumcision for religious reasons were randomly assigned to undergo either the sleeve technique (Group A) or the dorsal slit technique (Group B). Postoperatively, patients were followed-up on the 3rd, 7th, and 14th day. Data included variables such as intraoperative blood loss, postoperative complications, wound healing time, operative time, postoperative pain and surgeon’s comfort. Categorical variables were presented in the form of percentages. The association between categorical variables was tested using Chi-square tests and p-value < 0.05 was considered statistically significant. Results: A total of 27 patients had blood loss of more than 50 mL. A total 19 (63.3%) of the 27 patients belonged to Group B, while 8 (26.7%) patients were a part of Group A. Operative time was extended in sleeve technique as opposed to dorsal slit technique (58.84 min vs. 54.77 min, p-value=0.020). Complications were noted more in dorsal slit technique than in sleeve (33.3% vs. 10%, p-value=0.028). Moderate pain was more common after dorsal slit technique than after the sleeve technique (40% vs. 16.7%, p-value=0.045). Delayed wound healing was noted more in the patients subjected to dorsal slit technique (76.7% vs. 36.7%, p-value=0.002). The surgeon’s comfort was found to be more in dorsal slit technique than with sleeve technique (10% vs. 56.7%, p-value=0.001). Conclusion: The sleeve technique of circumcision showed lesser intraoperative bleeding, faster healing, lesser postoperative pain and complications as compared to the conventional dorsal slit technique.
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spelling doaj-art-ef6612c2aa2c4b83a2bd29bdc493b9e12025-01-28T11:48:48ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2025-01-011901091310.7860/JCDR/2025/74061.20550Comparison of Intraoperative and Postoperative Outcomes of Sleeve and Dorsal Slit Technique of Circumcision: A Prospective Interventional StudyN Snigdha0R Lakshmana1Das Debarath2Natarjan Soorya3A Pravindhas4M Malar Mannan5Junior Resident, Department of General Surgery, SRM Institute of Science and Technology, Chennai, Tamil Nadu, India.Professor, Department of General Surgery, SRM Institute of Science and Technology, Chennai, Tamil Nadu, India.Associate Professor, Department of General Surgery, SRM Institute of Science and Technology, Chennai, Tamil Nadu, India.Assistant Professor, Department of General Surgery, SRM Institute of Science and Technology, Chennai, Tamil Nadu, India.Senior Resident, Department of General Surgery, SRM Institute of Science and Technology, Chennai, Tamil Nadu, India.Junior Resident, Department of General Surgery, SRM Institute of Science and Technology, Chennai, Tamil Nadu, India.Introduction: Circumcision is the excision of the foreskin of the penis. Adult circumcision, although less prevalent, produces more discomfort and carries a fair share of complications if not performed meticulously. The dorsal slit technique and sleeve technique are the most followed techniques, the dorsal slit being the conventional method. Aim: To compare the intraoperative and postoperative outcomes of the dorsal slit technique and sleeve technique of circumcision. Materials and Methods: A prospective interventional study was conducted at SRM Medical College Hospital and Research Centre, Chennai, Tamil Nadu, India from October 2022 to April 2024. Sixty patients diagnosed with phimosis, balanoposthitis, paraphimosis and patients who requested circumcision for religious reasons were randomly assigned to undergo either the sleeve technique (Group A) or the dorsal slit technique (Group B). Postoperatively, patients were followed-up on the 3rd, 7th, and 14th day. Data included variables such as intraoperative blood loss, postoperative complications, wound healing time, operative time, postoperative pain and surgeon’s comfort. Categorical variables were presented in the form of percentages. The association between categorical variables was tested using Chi-square tests and p-value < 0.05 was considered statistically significant. Results: A total of 27 patients had blood loss of more than 50 mL. A total 19 (63.3%) of the 27 patients belonged to Group B, while 8 (26.7%) patients were a part of Group A. Operative time was extended in sleeve technique as opposed to dorsal slit technique (58.84 min vs. 54.77 min, p-value=0.020). Complications were noted more in dorsal slit technique than in sleeve (33.3% vs. 10%, p-value=0.028). Moderate pain was more common after dorsal slit technique than after the sleeve technique (40% vs. 16.7%, p-value=0.045). Delayed wound healing was noted more in the patients subjected to dorsal slit technique (76.7% vs. 36.7%, p-value=0.002). The surgeon’s comfort was found to be more in dorsal slit technique than with sleeve technique (10% vs. 56.7%, p-value=0.001). Conclusion: The sleeve technique of circumcision showed lesser intraoperative bleeding, faster healing, lesser postoperative pain and complications as compared to the conventional dorsal slit technique.https://www.jcdr.net/articles/PDF/20550/74061_CE[Ra1]_F(SHU)_QC(SD_SHU)_PF1(AG_SL)_PFA_NC(IS)_PN(IS).pdfbleedingforeskinhealingpainpenisphimosisparaphimosis
spellingShingle N Snigdha
R Lakshmana
Das Debarath
Natarjan Soorya
A Pravindhas
M Malar Mannan
Comparison of Intraoperative and Postoperative Outcomes of Sleeve and Dorsal Slit Technique of Circumcision: A Prospective Interventional Study
Journal of Clinical and Diagnostic Research
bleeding
foreskin
healing
pain
penis
phimosis
paraphimosis
title Comparison of Intraoperative and Postoperative Outcomes of Sleeve and Dorsal Slit Technique of Circumcision: A Prospective Interventional Study
title_full Comparison of Intraoperative and Postoperative Outcomes of Sleeve and Dorsal Slit Technique of Circumcision: A Prospective Interventional Study
title_fullStr Comparison of Intraoperative and Postoperative Outcomes of Sleeve and Dorsal Slit Technique of Circumcision: A Prospective Interventional Study
title_full_unstemmed Comparison of Intraoperative and Postoperative Outcomes of Sleeve and Dorsal Slit Technique of Circumcision: A Prospective Interventional Study
title_short Comparison of Intraoperative and Postoperative Outcomes of Sleeve and Dorsal Slit Technique of Circumcision: A Prospective Interventional Study
title_sort comparison of intraoperative and postoperative outcomes of sleeve and dorsal slit technique of circumcision a prospective interventional study
topic bleeding
foreskin
healing
pain
penis
phimosis
paraphimosis
url https://www.jcdr.net/articles/PDF/20550/74061_CE[Ra1]_F(SHU)_QC(SD_SHU)_PF1(AG_SL)_PFA_NC(IS)_PN(IS).pdf
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