Clinical Outcomes And Risk Factors In Patients Circumcised By Chinese Shang Ring: A Prospective Study Based On Age And Types Of Penile Disease

Figures & data

Figure 1 Normal process of circumcision with CSR. Wearing the CSR: adults (A) and children (D), the CSR removal: adults (B) and children (E) and wound healed: adults (C) and children (F).

Table 1 Distribution Of Complications And Prognostic Indicators For Different Disease And Age Groups

Items	Total	Types Of Disease		P value	Age (Development Of Penis)			P value
		Phimosis	Redundant Prepuce		≤ 11 (Undeveloped)	12–16 (Under-Developing)	≥17 (Developed)	≤ 11 vs 12–16	12–16 vs ≥17	≤ 11 vs ≥17
Number of patients (%)	657 (100.00)	240 (36.53)	417 (63.47)	-	243 (36.99)	158 (24.05)	256 (38.96)	-	-	-
Long-term complications	35 (5.30)	26(10.80)	9 (2.20)	<0.001	24 (9.90)	6 (3.80)	5 (2.00)	0.024	0.257	<0.001
Total complications	77 (11.70)	51(21.30)	26 (6.20)	<0.001	39 (16.00)	13 (8.20)	25 (9.80)	0.023	0.599	0.036
Satisfaction	642 (97.70)	227 (94.60)	415 (99.50)	<0.001	230 (94.70)	156 (98.7)	256 (100.00)	0.035	0.071	<0.001
Successful circumcision	622 (94.70)	214 (89.20)	408 (97.80)	<0.001	219 (90.10)	152 (96.80)	251 (98.00)	0.024	0.257	<0.001
Mean (SD)
Surgery time	5.75 (2.27)	7.66 (1.64)	4.65 (1.80)	<0.001	7.87 (1.25)	6.33 (1.17)	3.37 (0.86)	<0.001	<0.001	<0.001
Wound healing time	21.15 (5.05)	25.45 (3.53)	18.68 (4.03)	<0.001	25.28 (3.77)	20.77 (4.11)	17.48 (3.44)	<0.001	<0.001	<0.001

Abbreviations: CSR, Chinese Shang Ring; SD, standard deviation.

Table 2 Comparison Of Complications And Prognostic Indicators In Different Subgroups

Indexes	P value
	Phimosis			Redundant Foreskin
	≤ 11 vs 12–16	12–16 vs ≥17	≤ 11 vs ≥17	≤ 11 vs 12–16	12–16 vs ≥17	≤ 11 vs ≥17
Surgery time	<0.001	<0.001	<0.001	<0.001	<0.001	<0.001
Wound healing time	<0.001	0.097	<0.001	<0.001	<0.001	<0.001
Long-term complications	0.047	0.123	0.437	0.024	0.257	<0.001
Total complications	0.211	0.827	0.121	0.023	0.599	0.036
Satisfaction	0.161	0.098	0.041	0.035	0.071	<0.001
Successful circumcision	0.045	0.121	0.421	0.024	0.257	<0.001

Table 3 Distribution Of Complications And Prognostic Indicators For Different Disease (phimosis And Redundant Prepuce) And Age Segments (10–14, 15–29 And 30–49 Years)

Items	Total	Types of Disease		P value	Age (Years)			P value
		Phimosis	Redundant Prepuce		10–14	15–29	30–49	10–14 vs 15–29	15–29 vs 30–49	10–14 vs 30–49
Number of patients (%)	503 (100.00)	151 (30.01)	352(69.98)	-	184 (36.58)	179 (35.58)	140 (27.83)	-	-	-
Long-term complications	17 (3.38)	12(7.95)	5(1.42)	<0.001	11 (9.90)	5 (3.80)	1(2.00)	<0.001	0.314	<0.001
Total complications	48 (11.70)	31(21.30)	14(6.20)	<0.001	21 (11.41)	19 (10.61)	8(5.71)	0.007	0.687	0.014
Satisfaction	493 (98.10)	144 (95.36)	349(99.15)	<0.001	175 (95.10)	177 (98.88)	140 (100.00)	0.012	0.087	<0.001
Successful circumcision	486 (96.62)	138 (91.39)	348(98.86)	<0.001	175 (95.10)	173 (96.65)	138 (98.57)	0.009	0.342	<0.001
Mean (SD)
Surgery time	5.59 (2.14)	7.92 (1.32)	4.59(1.08)	<0.001	6.78 (1.12)	6.19 (0.98)	3.27 (0.67)	<0.001	0.036	<0.001
Wound healing time	19.05 (4.47)	22.36 (3.28)	17.63(3.56)	<0.001	21.65 (3.57)	18.78 (4.23)	15.98 (2.94)	<0.001	0.012	<0.001

Abbreviations: CSR, Chinese Shang Ring; SD, standard deviation.

Figure 2 The types of complication. Edema and scar (A), edema in the back side of penis (B), pressure dressing (C), effusion of yellowish fluid caused by phimosis when wearing CSR (D) and CSR removal (E) and wound dehiscence (F).

Figure 3 The degree of pain for different age (A) and types of disease (B) in different phase of post-operation.

Table 4 The Types And Distribution Of Complications In Different Subgroups

	Types of Disease		P	Age			P	Total
	Phimosis	Redundant Foreskin		≤ 11	12–16	≥17
Mean (SD)
Pain
Wearing the CSR
24 hrs	6.94 (1.29)	6.61 (1.21)	<0.001	7.12 (1.26)	6.42 (1.22)	6.56 (1.15)	<0.001	6.73 (1.25)
3 days	4.96 (0.79)	3.83 (0.81)	<0.001	5.1 (0.63)	4.3 (0.68)	3.39 (0.57)	<0.001	4.24 (0.97)
7 days	3.88 (0.56)	2.8 (0.7)	<0.001	3.85 (0.58)	3.2 (0.60)	2.57 (0.67)	<0.001	3.19 (0.83)
CSR removal	7.12 (0.67)	6.94 (0.6)	<0.001	7.21 (0.66)	6.86 (0.60)	6.9 (0.58)	<0.001	7.00 (0.63)
24 hrs	3.14 (0.72)	2.15 (0.76)	<0.001	3.21 (0.61)	2.73 (0.61)	2.72 (0.43)	<0.001	2.51 (0.88)
3 days	2.43 (1.23)	2.45 (1.25)	<0.001	1.22 (0.63)	2.33 (0.53)	3.65 (0.49)	<0.001	2.55 (1.25)
7 days	1.26 (0.45)	1.29 (0.61)	0.139	0.91 (0.32)	1.11 (0.35)	1.68 (0.51)	<0.001	1.27 (0.56)
Number
Edema
Wearing the CSR	89	76	<0.001	85	44	36	<0.001	165
CSR removal
24 hrs	69	50	<0.001	70	31	18	<0.001	119
3 days	41	23	<0.001	38	17	9	<0.001	64
7 days	24	7	<0.001	21	10	0	<0.001	31
The last follow-up	14	2	<0.001	14	2	0	<0.001	16
Bleeding of incision	3	3	0.489	2	0	4	0.263	6
Infection	4	0	0.008	4	0	0	0.032	4
Shifting of ring	0	8	0.032	0	0	8	0.002	8
Wound dehiscence	10	2	0.001	1	1	10	0.098	12
Scar hyperplasia	6	2	0.023	5	1	2	0.320	8
Uncomfortable feeling	10	6	<0.001	9	3	4	0.265	16

Abbreviations: CSR, Chinese Shang Ring; SD, standard deviation.