Efficacy And Safety Of Three Circumcision For The Treatment Of Prepuce And Phimosis: Meta Analysis

Objective: To compare and evaluate effectivenes and safety disposable circumcision suture device(DCSD),and Shang Ring circumcision(SRC),with conventional circumcision(CC)in the treatment of redundant prepuce and phimosis.Methods: The randomized controlled trials(RCTs)of Chinese and English studies about DCSD vs RSC and DCSD vs CC for the treatment of redundant prepuce or phimosis in China and abroad were searched by Pub Med,EMBASE,Medline,Cochrane Central Register of Controlled Trials,Google Scholar,CSCD,CBM disc,and CNKI,as well as manual search of five Chinese journals: Chinese of Journal Androloy,National Journal of Androlgy,Chinese Journal of Urology,Journal of Clinical Urolog.Two reviewers independently screened the studies for eligibility,evaluated the quality and extracted the data.The Review Manager v.5.1.0meta analysis.Results: In the literature,15 RCTS.Its baseline comparable.Meta analysis showed:(1)Safety: Compared with the CC group,the DCSD group had a shorter operative time,a shorter incision healing time,less intra-operative blood loss,a lower intra-operative pain score,a lower postoperative pain score,and a lower rate of adverse events(educe the incidence of infection).There were no differences between the CC and DCSD groups in the incidences of dehiscence,hematoma,and incision edema.Compared with the SRC group,the DCSD group had a shorter operative time,a shorter incision healing time,a lower intra-operative pain score,a lower postoperative pain score,lighter incision edema,and a lower rate of adverse events(educe the incidence of infection and hematoma).There were no differences between the SRC and DCSD groups in the incidences of dehiscence,intra-operative blood loss,and operative time.(2)Effectiveness:The DCSD group had a better cosmetic penile appearance other two kinds of operative methods.(3)Surgery cost: The DCSD group operation costs are higher than other two kinds of operative methods.Conclusion: Meta analysis showed: the three kinds of circumcision are safe and effective means for the treatment of redundant prepuce and phimosis.But the DCSD appears to be a safer and more standardization and routinization than CC and SRC.However,due to the limited incorporated in the literature,additional high-quality,RCTs with larger study populations are needed.