Stapler Options for Adult Circumcision: CircCurer vs. ZSR Circumcision Stapler Devices
I. Introduction
In the UK, new stapler options for adult circumcision have been introduced.
We look at the performance, postoperative healing, complications, and stapler removal rate of two disposable circumcision stapler devices used in adult male circumcision: CircCurer and ZSR.
II. Comparison of CircCurer and ZSR Circumcision Stapler devices
A. Operative Efficiency and Safety
1. Performance in operative time
2. Complication rates
3. Infection and bleeding rates
Operative Efficiency and Safety: Both stapler devices demonstrated similar performance in operative time (around 7 minutes) and complication rates. Patients experienced minimal infections and hematomas in both groups, underscoring the safety of these devices. Pain scores were comparable between the CircCurer and ZSR stapler circumcision groups.
B. Postoperative Considerations
1. Healing outcomes
2. Swelling rates
3. Stapler’s removal rates
Postoperative Considerations: While both devices resulted in successful circumcision, some subtle differences emerged regarding post-surgical experiences. The CircCurer group showed a slightly higher swelling rate (oedema) than ZSR. However, a significant difference arose with staple removal. The ZSR group had a substantially higher incidence of staples spontaneously falling out (62.9%) than the CircCurer group (38%).
III. Patient Satisfaction and Considerations
A. Patient satisfaction levels
B. Healing time comparison
C. Staple removal considerations
Despite the difference in staple retention, patients in both groups reported remarkably high satisfaction levels at the two-month follow-up, instilling confidence in the effectiveness of these devices. However, it's essential to consider some additional factors when choosing a stapler device for adult circumcision:
Healing Time: At two months, patients of both groups reported satisfaction with the outcome. This means that stapler circumcision takes longer to heal compared to traditional methods of circumcision.
Staple Removal: The study highlighted that ZSR exhibited a higher rate of staple fallout, necessitating an additional follow-up procedure for removal in the CircCure method, sometimes requiring local anaesthesia. More patients (40-60%) in the CircCurer group must return for a follow-up procedure to remove the staplers
IV. Making an Informed Decision
A. Empowering doctors to make informed choices.
B. Factors for patient consideration
C. Highlighting distinctions in stapler devices
This information provides valuable insights for doctors and patients considering stapler circumcision for adults. While both CircCurer and ZSR proved effective and safe for the procedure, the higher rate of staple fallout with ZSR is a noteworthy distinction. Understanding these differences empowers doctors and patients to actively participate in decision-making, selecting the most suitable device based on individual needs and preferences.
V. Conclusion
A. Summary of benefits of both devices
B. Noteworthy distinctions
C. Impact of healing time and staple removal on decision-making
In conclusion, both devices offer similar benefits, including short surgery times, low complication rates, and high patient satisfaction. However, the ZSR device showed a significantly higher rate of metal clips falling out spontaneously and less need for a follow-up procedure for staple removal. Healing time is much longer in stapler circumcision compared to traditional methods.
VI. References
Efficacy and safety of two disposable circumcision suture devices for circumcision in adults: a prospective comparative multicentre study, International Journal of Impotence Research June 2024, Italy, and Spain DOI:10.1038/s41443-024-00933-3
Circumcision devices versus standard surgical techniques in adolescent and adult male circumcisions: a Cochrane review. BJU Int. 2022 Jul; 130(1): 26–34. doi: 10.1111/bju.15604
Adult male circumcision with a circular stapler versus conventional circumcision: A prospective randomized clinical trial Braz J Med Biol Res. 2015 Jun; 48(6): 577–582. doi: 10.1590/1414-431X20154530
A Comparative Study on the Clinical Efficacy of Two Different Disposable Circumcision Suture Devices in Adult Males, Urol J 2017 Aug 29;14: 5013-17