Histopathological changes and surgical complications in thermocautery circumcision

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Abstract

Background
Circumcision is one of the most commonly performed surgical procedures worldwide. The operation excises the preputium and reveals the glans. Circumcisions are done to decrease the risk of urinary system infections, penile cancer, prostate cancer, cervical cancer, human papilloma virus, herpes simplex virus type 2, HIV, and other venereal diseases.
Aim
This study aimed to assess the outcome of using thermocautery in circumcision and the histopathological changes that occur to prepuce in comparison with the conventional surgical method.
Patients and methods
A prospective randomized study was done to assess the outcome of using thermocautery in circumcision in comparison with the conventional surgical method. The study was done at the General Surgery Department of Assiut University Hospital, which enrolled 106 male patients who were circumcised in the period between January 2021 and January 2022.
Results
When comparing both groups, we found that bleeding was present among 29.1% of cases (16 patients) operated by the standard scalpel technique, whereas no cases operated by thermocautery were recorded to have bleeding, as shown in Table 3. This was statistically significant (<0.001). Concerning postoperative reoperation for bleeding, this was statistically significant (=0.002). Histopathological examination of sections from the foreskin removed by a scalpel revealed a clean incision line with mild edema and mild congestion of blood vessels.
Conclusion
Thermocautery circumcision is a safe technique with low postoperative bleeding rate and less need for reoperation for bleeding. However, it causes higher rates of postoperative coagulative necrosis either full thickness or within a few millimeters.

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