Comparison of a modified Mogen clamp and classic dorsal slit circumcision under local anesthesia: A clinical study.

Background: Currently, although various methods are used, there is no gold standard method for circumcision. Therefore, we developed a modified circumcision clamp inspired by the Mogen clamp suitable for circumcisions performed under local anesthesia in our country. To evaluate its success and complications, we compared our modified Mogen clamp with a dorsal slit circumcision.

Materials and methods: From 2013 to 2017, we retrospectively evaluated 1309 patients who had undergone circumcision; of these, 832 used the modified Mogen clamp method (Group 1) and 477 used the dorsal slit method (Group 2). The patients' age, surgery duration, minor hemorrhage (not requiring suture or repeated surgical exploration after circumcision but with buffer or clotting solution used), major hemorrhage (hemorrhage requiring suture or exploration), redundant prepuce skin remnants, revision numbers, and family satisfaction values were evaluated and compared between the 2 groups.

Results: Patients were assessed at least 3 times: 1day, 1week, and 1month after circumcision. The mean ages in Groups 1 and 2 were 16.5±22.8 versus 15.5±18.8 months, respectively. The surgical procedure durations were 9.2±1.7 and 15.4±2.5 minutes in Groups 1 and 2, respectively (p < 0.001). Complications were found in 164 (19.7%) versus 81 patients (17.0%) (p = 0.522), including redundant skin in 42 (5.4%) versus 15 patients (3.14%) (p = 0.105) and major hemorrhage in 20 (2.4%) versus 15 patients (3.3%) (p = 0.230) in Groups 1 and 2, respectively.

Conclusion: Under local anesthesia, the circumcision procedure with the modified Mogen clamp can be performed more rapidly than with the dorsal slit, and the cosmetic results are better as the incision line is more regular. All postoperative complications were similar, with problems related to redundant skin occurring more frequently with clamp circumcision.