Approaches of circumcision and analysis
New generation laser circumcision
This is a new way of circumcision surgery researched and developed by our specialist. Thousands of patient had this new generation of laser circumcision and proved it to be safe and of good clinical outcomes.
New generation laser circumcision is performed with a carbon dioxide laser for cutting of the foreskin and at the same time, it cauterizes the cut edge. The cut wound is closed by surgical sutures and then further covered and strengthened with the new sterile medical super-glue.
After the laser cut and burn, the wound edge burnt tissue coagulates and forms a coagulum covering the free nerve endings of the wound edges. There will be less stimuli reaching the free nerve endings to sense and in turn less post-operative wound pain comparing with traditional circumcision using scalpel or scissor to cut wound.
New generation of sterile medical super-glue
New generation of sterile medical super-glue is a sterile medical grade super-glue made of cyanoacrylate glue (acrylic acid glue). It is being used to apply on the surface of the wound to hold the wound together, and it forms a protective layer to keep moisture (water-proof) and bacteria away from the wound (anti-bacterial). With the use of this super-glue, the risk of post-operatively bleeding and burst wound during erection wound be minimized. The is no need for regular wound cleansing every time after urination. Keeping the wound dry is essential. No removal of glue is needed as the glue wound dislodge spontaneously in a few weeks time with the normal skin exfoliation after surgery.
The new generation laser circumcision has the advantages of nearly zero post-operative wound pain, minimal intra-operative blood loss and no wound cleansing is required after each urination. Immediate return to school or work is allowed after the new generation laser circumcision. Normally moderate exercise could be performed 2 - 3 weeks afterwards. As the wound heals, sexual activities could be resumed 4 weeks after the new generation laser circumcision.
Adult pressure ring / bell circumcision
Adult pressure ring circumcision / bell circumcision is done by putting the inner pressure ring / pressure bell under the foreskin and strangulating the foreskin with an outer tight thread or an outer pressure ring. It would cause ischemia, necrosis and natural detachment of the distal ischemic foreskin.
As the adult foreskin is thicker, 7 - 14 days are required for spontaneous detachment of the distal foreskin together with the pressure ring/ pressure. There would be a ring-shaped wound of ≦1mm width over the penile shaft after the pressure ring and dead skin fell off. The ring-shaped wound usually heals in few days time.
The advantages of the method are less post-operative pain comparing with traditional circumcision, and good wound appearance without suturing mark. There is no need to clean the wound after voiding. Patients could return to school or work immediately after the procedure. Moderate exercise is possible after 2 to 3 weeks and sexual activities could be resumed in about 4 weeks.
Traditional circumcision is a surgical procedure involving cutting of the foreskin with scalpel or scissor and closing of the wound with ordinary surgical sutures. There is usually more blood loss during the surgery and the post-operative pain is usually moderate to severe.
Normal saline, distilled water, or antiseptic solution is required for post-operative wound cleansing every time after urination.
Students are expected to be absent from school for about 1 - 2 weeks.
Adults are expected to be absent from work for 1 - 2 weeks.
Patients could normally perform moderate exercise four weeks after surgery and sexual activities could be resumed 4-6 weeks post-operatively.
Comparison of different circumcisions
|Adult pressure ring / bell circumcision||New generation laser circumcision||Traditional Circumcision|
|Indications||Phimosis/ long prepuce/ paraphimosis/ recurrent balanitis / recurrent posthitis/ foreskin diseases|
|Location||Clinic / Hospital|
|Anesthesia||(Clinic) Local anesthesia/ (Hospital) General anesthesia|
|Surgery time||5-10 minutes||15-30 minutes||30-60 minutes|
|Earliest return to school or work||Immediate after surgery / next day||Immediate after surgery / next day||7-14 days|
|Position of penis posteratively||Upward fixation(the penis is prevented from hitting the surroundings and resulting in minimal pain during walking)||Upward fixation(the penis is prevented from hitting the surroundings and resulting in minimal pain during walking)||Downward and inside a paper cup(the penile wound hits the paper cup/ clothings and cause significant pain after every walking step)|
|Post operative wound care||No need wound cleaning. Just keep wound dry||No need wound cleaning. Just keep wound dry||Wound cleaning after each urination|
|Post operative pain||Minimal||Nearly zero||Moderate to severe|
|Post operative erection management||Use ice / numbing jelly||Use ice / numbing jelly||None|
|Return to moderate exercise||2 - 3 weeks||2 - 3 weeks||4 - 6 weeks|
|Resume sex||4 weeks||4 weeks||4 - 6 weeks|
|Post operative off stitches||Wound is healed naturely. Sutures are not used.||Seldom
(water soluble sutures are used)