Techniques of circumcision
Adult circumcision with CircCurer (LangHe) staple device (ZSR Circumcision)
First Private Clinic at London, UK that Offers Circumcision with this Novel CircCurer (LangHe) staples Device
Many patients are asking from Dr Khan to circumcise with ZSR or stapler devices. Adult circumcision can be performed by CircCurer (LangHe) staples suture device. Dr Khan has simulation training of CircCurer (LangHe) staples suture device.
Dr Khan offers circumcision with this new CircCurer (LangHe) staple device at The London Circumcision Clinic, Leyton, London.
Adult circumcision with CircCurer stapler is a quick procedure. When it was compared with the conventional circumcision with stitches, stapler circumcision is associated with shorter surgical time, higher patient satisfaction with penile looks, lower operative pain, less operative blood loss, and lower wound bleeding post-operatively. However, wound healing takes longer than traditional circumcision in adults.
Anaesthesia
A local anaesthetic is used for the circumcision with staplers and injected into the base of the penis and all around the shaft of the penis. This provides safe and effective pain-relief during the circumcision. This also minimises post-operative pain for a few hours.
Men's Circumcision Cost with CircCurer in the UK (16-YEAR-OLD AND ABOVE)
Circumcision with stapler Device £750 which includes consultation on the same day and one free follow up visit.
Informed Consent
We provide the patient with all the information about the stapler circumcision ahead of time. Stapler Circumcision is an irreversible procedure and makes the head of the penis exposed permanently. Informed consent is taken before the procedure.
Full or Partial Circumcision
Full circumcision means moderate cutting inner and outer foreskin to expose the full of head of the penis. Partial circumcision leaves loose skin, which partially covers the glans (head of penis). Partial circumcision may not work in all adults.
Full circumcision might give a false impression of loose/partial circumcision when the penis is in a flaccid state especially patient with a buried penis. Partial circumcision is possible, but it has a few complications in the long term. These can be talked with Dr Khan at Adult Circumcision Clinic in London, UK
Procedure Technique
Following are methods of adult and boys over 16-year-old for circumcision:
After local anaesthesia, foreskin retracted, and assess the suitability.
If there is scarring due to BXO, stapler circumcision is not advisable to perform.
Apply the bell of the instrument inside the foreskin
Secure the right position of the stapling device
Cut the skin and staples applied at the same time
Apply the bandage around the wound at the end of the circumcision
Recovery for Adult Circumcision with staplers
Circumcision with stapler heals quicker than one with stitches. Swimming and weight lifting should be avoided for 2-3 weeks. Full recovery following circumcision generally requires 4-6 weeks. Over-sensitivity of the glans may take a few months to resolve.
Adult Circumcision Healing Tips
To reduce the effect of night erections pulling on the staplers during the first few days after the adult circumcision, empty your bladder before retiring and a few times during the night. Sleep on your side or back. It may be helpful to draw your knees up a bit into a more foetal position. Wear tight underwear after the circumcision to prevent unnecessary movement. Follow the aftercare advice and keep the wound dry for 5 days.
Please take vitamin C regularly for 10 days to promote healing. Apply vitamin E cream, Mederma gel or bio-oil to the scar after 15 days if the staplers are completely off. This will improve the scaring. Please contact us at The London Circumcision Centre for further advice.
Medical evidence
Five recent studies involving 2026 men were included in the comparison of the stapler and conventional circumcisions with stitches. The statistically significant less incidence in circumcision with staplers were intra-operative blood loss, operating time, the mean pain score on the operation day, the mean pain scores on post-operation days and wound healing time. The majority of the patients (88.0%) required the removal of residual staples postoperatively after 4 weeks.
References:
Brazilian Journal of Medical and Biological Research (2015) 48: 577-582
Asian Journal of Andrology (2017) 19, 362–367
Scientific Report (2016) 6, 25514
Risk of Adult Circumcision
Risks of the circumcisions explain to the patients. Risks are failed staple procedure requiring traditional circumcision, bleeding, bruises, haematoma formation, infection, retaining of staplers more than 4 weeks, inadvertent damage to the glans, removal of too much or too little skin, lymphoedema, aesthetically displeasing results and a change of sensation during sexual activity.
The patient should also be informed that, during the postoperative period, erections can cause pain, bleeding and discomfort. Very small chances of disruption of the staples or scarring of wounds which might require a redo or revision circumcision.
Postoperative Care
You might experience discomfort for a few days after the circumcision, but painkillers help to decrease the discomfort. Passing urine is not usually affected by the circumcision. There will be swelling and bruising of the shaft of the penis for 2 to 3 weeks after the stapler circumcision. This will then subside gradually and should not be a cause for alarm. Bleeding after circumcision can be stopped by applying pressure or a bandage.
A dressing (bandage) is applied around the wound line to prevent the wound from sticking to your underclothes. A bandage will stay for 3 days with self-adhesive stretch gauze (Cobain). The wound will be at least 2-3 weeks before healing completes and you may return to work when you are comfortable enough.
Most people require at least 2-3 days off work. You should gently wash the wound daily after one week if the wound is dry and shower regularly. You should stop the gym or heavy weight lifting for 2 weeks. You should avoid from any sexual activity for 4-6 weeks after the circumcision to avoid breakdown of the wound.
Follow up visit
Some of the staplers come off itself. However, there are some staples remain over the wound after 3 weeks. All patients require to arrange an appointment after 3-4 weeks so that we must remove the residual staples.
PS: This information is for suggestion only. This is not a substitute for professional medical advice. Please call to Dr. Khan for free telephone advice +447527314081 without any obligation.
© London Circumcision Centre, 2019. Unauthorised use and duplication of this blog without express and written permission from this blog’s author and owner is strictly prohibited.
Aftercare Instructions for Glue Circumcision
How do I look after a circumcision treated with skin glue?
Skin glue is a special medical adhesive gel that applies to the circumcision wound edges. It can be used on its own or with stitches. It takes only 3-5 minutes to dry to set and form a thin layer over the wound. It forms a protecting waterproof coating over your circumcision wound. Glue circumcision is the best way of circumcision.
How does skin glue work at circumcision wounds?
The inner and outer foreskin has edges that can be easily joined together by medical liquid glue by a special technique.
Will glue get separated during the erection of the penis?
No, glue is strong enough to stay on the skin during your erection in our special technique of glue circumcision.
Why is the skin glue used in circumcision?
This will give a waterproof seal, less pain, less risk of infection and better results as compared to stitches
Can glue use in redo or revisions circumcision?
Yes, redo or revision circumcision with glue gives the best outcome of the previous scar. Glue revision circumcision is the best method
How long does glue stay on the circumcision wound?
The glue usually comes off itself within 5-15 days
Will I feel pain after glue circumcision?
For the first few days, you may feel pain and use simple pain relief medication. Take simple over-the-counter painkillers for a few days. Glue circumcision is less painful the circumcision with stitches only. The head of the penis (glans) remains very sensitive after circumcision, you can apply a small amount of Vaseline or olive oil only to the glans penis. Sensitivity may last many weeks or months.
How do I care for a circumcision treated with skin glue?
Please follow the aftercare advice from Dr Khan
Wash your hand before you touch/change the bandage
Only wear tight underwear with the head of the penis upwards toward the belly button.
Avoid soiling the bandage with urine
Do not touch the glue for 4 days
Keep the circumcision wound dry for the first 4 days
Keep the bandage for 4 days and take showers after 4 days. Afterwards, change the bandage daily for 7 days after applying Fucidin cream only on the stitches
No bath for 15 days to prevent soaking the wound
Wrap the circumcision wound with cling film if you like to take a shower before 4 days.
Pat the circumcision site dry if the wound gets wet – don't rub the glue site and do not apply any cream and antiseptic solution to the glue
If wound edges join together securely and the glue is still in place after 15 days, you can remove the glue in the shower.
Apply bio-oil on the wound after 4 weeks for 2-3 months to decrease the scarring
What are things to avoid during the healing of the circumcision with glue?
Do not scratch, rub, or pick at the glue; doing so may loosen the film before the wound is fully healed
Do not soak or scrub your wound for 15 days.
Do not swim until the adhesive film (glue) has fallen off naturally
Do not apply liquid or ointment medications or any other product to the wound while the glue is in place. It could loosen the glue film before the wound is fully healed
Do not do any heavy lifting, gym or exercise for 2 weeks
Do not do any sexual activities for 4-6 weeks
How long swelling or bruising will settle down?
The shaft of the penis will have swelling for 4-6 weeks and bruising of the glans and shaft of the penis will settle with 4 weeks.
How long frenulum is will heal?
If you have frenuloplasty with glue circumcision, we put a few stitches covered by glue at the frenulum which will take longer (about 4 weeks) to heal. Apply Fucidin cream after changing the bandage. The frenulum area will heal later than circumcision site.
When should I get help from Doctor?
Most circumcision wounds are sealed with skin glue heal normally with excellent results. You should get medical help from our specialist doctors if:
Your wound gaps open or starts to bleed
You think your wound may be infected
What are the symptoms of wound infection?
The circumcision wound look redder or swollen
The pain in the wound gets worse after 3 days
Discharge of pus or blood comes from the circumcision wound
You have a fever of 38C (100.4F) or more
Wound edges get separated with bleeding
Please contact our doctors for medical advice if you have any questions.
Written by a patient at Leyton Clinic, London, February 2020
“I got circumcised by Dr Khan using the glue method and I can only praise both the surgeon and the technique. He was extremely friendly and approachable. I had a long list of question before the procedure which he happily answered over the phone. Booking an appointment was very easy and hassle-free. On the day of the operation, Dr Khan asked me about all my wishes and preferences and gave me personalised suggestions. The operation itself was virtually completely painless. I kept talking to Dr Khan and his lovely nursing assistant throughout the procedure. Having followed his post-operative care plan to the letter, my recovery was very quick and uneventful. I only needed to take simple over-the-counter painkillers (paracetamol and ibuprofen) for 2 days. The pain was completely gone after that. The swelling settled in about a week. As I'm writing this review, I am only 4 weeks post-op and it feels like I have been circumcised forever. The glue method achieved an excellent cosmetic result. I cannot recommend Dr Khan highly enough.”
© London Circumcision Centre, 2023. Unauthorised use and duplication of this blog without express and written permission from this blog’s author and owner is strictly prohibited.
What is the Best Circumcision Method for Male Adult
Methods and techniques of circumcision for boys age 16 and over
What is the best circumcision method for men ?
Many patients are asking from surgeons or urologists about different ways of to circumcise male adult. Patients look into Google to find the answer, but they become more confused.
There are different techniques and methods for the circumcisions:
Forceps guided method
Sleeve method
Clamp method
Freehand method
These procedures can be achieved by using glue, stitches, Shang ring device, ZSR or CircCurer (LangHe) staplers, or combinations of these.
What is evidence in the medical literature
Adult circumcision with Shang ring
Pros
1. Quick and bloodless
2. Higher patient satisfaction
3. Lower operative pain
4. Lower risks
5. Small wound bleeding
Cons
1. Wound healing takes longer to heal
2. Significant Wound gap
3. Healing by significant scar gaps in some cases
4. Require removal of the ring
5. More pain during recovery
Circumcision with a Stapler device (ZSR or CirCurer)
Pros
1. Less operative time
2. Less operative pain
3. Less complications
4. Lower infection rate
5. Short healing time
6. Less swelling
Cons
1. Residual stapler nails longer than 4 weeks
2. Staples requires removal
3. May leave stapler marks
Circumcision with stitches
Pros
1. Less expansive
2. Easy to use
3. Customised as patient requirements
Cons
1. Leave stitches marks and tunnels
2. Stitches take 2-3 weeks to fall off
3. More painful than glue
4. More chances of infection
Circumcision with glue
Pros
1. Waterproof
2. Less bleeding
3. Less chance of infection
4. Less painful
5. Heals quicker
6. Best in cosmetic outcome
Cons
1. Operation is longer
2. Technically challenging
3. Expansive operation
In conclusion, a recent report showed that the use of tissue glue in comparison to stitches is cosmetically better and has less complications.
By looking the medical literature, photos on the internet, our results with the ”Khan technique of circumcision” were superior to all other methods and these results are endorsed by many patient’s feedback.
The Khan Technique of the Circumcision: He uses his own surgical techniques using mainly glue with 1-3 stitches, which is a custom made result for every individual patient. With his 27 years experience, the “Khan technique of the circumcision” is the best circumcision method of adult and boys over 16 years of age.
Dr. Khan can discussed about the initial outcome and long term about the “Khan technique of glue circumcision”
© London Circumcision Centre, 2019. Unauthorised use and duplication of this blog without express and written permission from this blog’s author and owner is strictly prohibited.
