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Conventional vs. device-assisted paediatric circumcision: A systematic review and meta-analysis
Abdul-Hadi Kafagi1, Ahmed E Ibrahim2, Zaidi Hamid3
1Department of Urology, Wythenshawe Hospital, Manchester University Hospitals NHS Foundation Trust, Manchester, UK.
Journal of Pediatric Urology
|August 1, 2025
Summary
Device-assisted paediatric circumcision offers shorter operative times and less bleeding than conventional methods. While complications are similar, more research is needed to confirm these benefits for pediatric circumcision procedures.
Area of Science:
- Pediatric Surgery
- Urology
- Medical Devices
Background:
- Paediatric circumcision is a common procedure with varying techniques.
- Conventional scalpel-based methods and device-assisted techniques are widely used.
- Comparative safety and efficacy data are crucial for clinical decision-making.
Purpose of the Study:
- To systematically compare the safety, efficacy, and postoperative outcomes of conventional versus device-assisted paediatric circumcision.
- To evaluate primary outcomes such as bleeding, infection, and reoperation rates.
- To assess secondary outcomes including operative time and costs.
Main Methods:
- Systematic review of randomized controlled trials and cohort studies up to March 2025.
- Inclusion criteria focused on paediatric patients (<18 years) comparing the two techniques.
- Primary outcomes included bleeding, infection, delayed healing, and reoperation; secondary outcomes were operative time and cost.
Main Results:
- Twenty-three studies involving 23,490 patients were analyzed.
- Device-assisted circumcision showed significantly shorter operative time and reduced post-operative bleeding.
- No significant differences were found in most complication rates, though trends favored device-assisted methods in RCT subgroup analysis.
Conclusions:
- Device-assisted paediatric circumcision may offer advantages in operative time and bleeding reduction.
- Most complication rates were comparable between techniques, but evidence quality is limited by heterogeneity and observational data.
- Larger, high-quality randomized controlled trials are necessary to validate these findings and inform clinical practice.
