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Bocchino AC, Fernández-Pascual E, Toribio-Vázquez C, Manfredi C, Urdaneta G, Balmori C, Lledó E, Martínez-Ballesteros C, Cocci A, Mondaini N, Martínez-Salamanca JI. Efficacy and safety of two disposable circumcision suture devices for circumcision in adults: a prospective comparative multicenter study. Int J Impot Res 2024:10.1038/s41443-024-00933-3. [PMID: 38886594 DOI: 10.1038/s41443-024-00933-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 06/01/2024] [Accepted: 06/10/2024] [Indexed: 06/20/2024]
Abstract
The objective of this study was to evaluate and compare efficacy and safety of two different Disposable circumcision suture devices (DCSDs). A prospective comparative non-randomized multicenter study was performed between November 2019 and February 2023. Patients underwent circumcision using a DCSD (CircCurerTM or the ZSR® device) according to the surgeon preference and device availability. A total of 378 patients were circumcised; 184 using CircCurerTM and 194 patients using ZSR®. No differences in baseline characteristics were observed. CircCurer and ZSR Groups showed similar rates of operative time (7.7 ±2.1 vs 7.3 ±2.0 min), surgical site infection (1.1% Vs 1.5%), edema (13% Vs 8.2%), hematomas (2.7% Vs 1.1%), and postoperative pain (2.5 Vs 2.0 points). ZSR Group had a significantly higher rate of clip fallout (62.9% Vs 38%, p < 0.001). At 2 months, patients of both groups reported a median satisfaction of 9 (8-9) points. Main limitation consist in non-randomized study. DCSDs seem to be effective and safe, with short operative times, uncommon and mild complications, and high patient satisfaction. ZSR® device has a higher rate of spontaneous staple dropout.
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Affiliation(s)
| | - Esaú Fernández-Pascual
- LYX Institute of Urology, Universidad Francisco de Vitoria, Madrid, Spain.
- Department of Urology, Hospital Universitario La Paz, Madrid, Spain.
| | | | - Celeste Manfredi
- Urology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Guillermo Urdaneta
- LYX Institute of Urology, Universidad Francisco de Vitoria, Madrid, Spain
| | - Carlos Balmori
- LYX Institute of Urology, Universidad Francisco de Vitoria, Madrid, Spain
| | - Enrique Lledó
- LYX Institute of Urology, Universidad Francisco de Vitoria, Madrid, Spain
- Department of Urology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Claudio Martínez-Ballesteros
- LYX Institute of Urology, Universidad Francisco de Vitoria, Madrid, Spain
- Department of Urology, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | - Andrea Cocci
- Department of Urology, University of Florence, Careggi Hospital, Florence, Italy
| | - Nicola Mondaini
- Department of Urology, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Juan Ignacio Martínez-Salamanca
- LYX Institute of Urology, Universidad Francisco de Vitoria, Madrid, Spain
- Department of Urology, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
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Coşkun İ, Yalçın O. Evaluating Caudal Block Enhancements in Pediatric Circumcision: Do Additional Analgesics Make a Difference? Med Sci Monit 2023; 29:e942557. [PMID: 37904341 PMCID: PMC10625336 DOI: 10.12659/msm.942557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 10/16/2023] [Indexed: 11/01/2023] Open
Abstract
BACKGROUND Caudal block is widely regarded as the top choice for multimodal analgesia in children undergoing urological surgeries, particularly circumcision. This study investigates the efficacy of caudal block and the necessity of rescue analgesia in circumcision surgeries. MATERIAL AND METHODS A prospective, single-blind study was conducted at Ordu University Training and Research Hospital from December 1, 2022, to July 1, 2023. The study randomly divided ASA class I-II children aged 1-12 years into 3 groups for circumcision surgery. Group C received only caudal block. Group CP received caudal block with 10 mg/kg intravenous paracetamol. Group CM received caudal block with 1 mg/kg intravenous meperidine. In each case, a caudal block was administered using 0.5 ml/kg of 0.125% bupivacaine under ultrasound guidance. The primary outcome of the study was total analgesic consumption; the secondary outcomes were pain scores and time to first analgesic administration. Pain severity was evaluated using FLACC and Wong-Baker scores at 0, 1, 4, and 24 h. RESULTS A total of 120 patients, 40 patients in each group, were included in the study. A significant difference was detected among all 3 groups in the Wong-Baker pain score (24th hour) (P<0.001). The FLACC and Wong-Baker pain scores did not differ significantly in the other time frames. The time of the first rescue analgesia and the total amount of analgesic taken in the first 24 h were the same for both groups (P=0.408 and P=0.238). CONCLUSIONS The addition of paracetamol or meperidine to caudal block does not enhance the quality of analgesia.
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Affiliation(s)
- İlker Coşkun
- Department of Anesthesia and Reanimation, Ordu University Faculty of Medicine, Altınordu/Ordu, Turkey
| | - Onur Yalçın
- Department of Pediatric Surgery, Ordu University Faculty of Medicine, Altınordu/Ordu, Turkey
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ÇEVİKKALP E, BAYTAR Ç. Comparison of postoperative analgesic effectiveness of caudal block, dorsal penile nerve block, and pudendal nerve block in children undergoing circumcision. CUKUROVA MEDICAL JOURNAL 2022. [DOI: 10.17826/cumj.1020556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Topical and systemic analgesia versus caudal epidural and dorsal penile nerve block in relieving pain after pediatric circumcision. MARMARA MEDICAL JOURNAL 2021. [DOI: 10.5472/marumj.1013317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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