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Comparison of a modified Mogen clamp and classic dorsal slit circumcision under local anesthesia: A clinical study
1Department of Urology, Private Safa Hospital, Istanbul, Turkey.
Background:
Currently, although various methods are used, there is no gold standard method for circumcision. Therefore, we developed a modified circumcision clamp inspired by the Mogen clamp suitable for circumcisions performed under local anesthesia in our country. To evaluate its success and complications, we compared our modified Mogen clamp with a dorsal slit circumcision.
Materials And Methods:
From 2013 to 2017, we retrospectively evaluated 1309 patients who had undergone circumcision; of these, 832 used the modified Mogen clamp method (Group 1) and 477 used the dorsal slit method (Group 2). The patients' age, surgery duration, minor hemorrhage (not requiring suture or repeated surgical exploration after circumcision but with buffer or clotting solution used), major hemorrhage (hemorrhage requiring suture or exploration), redundant prepuce skin remnants, revision numbers, and family satisfaction values were evaluated and compared between the 2 groups.
Results:
Patients were assessed at least 3 times: 1day, 1week, and 1month after circumcision. The mean ages in Groups 1 and 2 were 16.5±22.8 versus 15.5±18.8 months, respectively. The surgical procedure durations were 9.2±1.7 and 15.4±2.5 minutes in Groups 1 and 2, respectively (p < 0.001). Complications were found in 164 (19.7%) versus 81 patients (17.0%) (p = 0.522), including redundant skin in 42 (5.4%) versus 15 patients (3.14%) (p = 0.105) and major hemorrhage in 20 (2.4%) versus 15 patients (3.3%) (p = 0.230) in Groups 1 and 2, respectively.
Conclusion:
Under local anesthesia, the circumcision procedure with the modified Mogen clamp can be performed more rapidly than with the dorsal slit, and the cosmetic results are better as the incision line is more regular. All postoperative complications were similar, with problems related to redundant skin occurring more frequently with clamp circumcision.
Insights
A modified Mogen clamp offers a faster circumcision procedure under local anesthesia compared to the dorsal slit method. While overall complications are similar, clamp circumcision resulted in more redundant skin.
Area of Science:
- Urology
- Surgical Innovation
- Pediatric Surgery
Background:
- No universally accepted gold standard exists for circumcision techniques.
- A modified Mogen clamp was developed for circumcisions under local anesthesia.
Purpose of the Study:
- To evaluate the efficacy and safety of a modified Mogen clamp compared to the dorsal slit method for circumcision.
- To compare surgical outcomes, including duration, complications, and cosmetic results.
Main Methods:
- Retrospective evaluation of 1309 patients undergoing circumcision from 2013-2017.
- Group 1: 832 patients (modified Mogen clamp). Group 2: 477 patients (dorsal slit).
- Comparison of age, surgery duration, hemorrhage, skin remnants, revisions, and family satisfaction.
Main Results:
- Modified Mogen clamp procedure was significantly faster (9.2±1.7 min vs 15.4±2.5 min, p < 0.001).
- Overall complication rates were similar (19.7% vs 17.0%, p = 0.522).
- Redundant skin was more frequent with the modified Mogen clamp (5.4% vs 3.14%, p = 0.105).
Conclusions:
- The modified Mogen clamp allows for rapid circumcision under local anesthesia with superior cosmetic outcomes.
- Postoperative complications were comparable between the two methods, though redundant skin was more common with the clamp.
