A PROSPECTIVE RANDOMIZED COMPARISON BETWEEN CONVENTIONAL DORSAL SLIT TECHNIQUE AND MODIFIED DORSAL SLIT TECHNIQUE FOR CIRCUMCISION

Circumcision is a very common surgical operation practiced in many societies since ancient past for religious purposes. There are several methods and each methods have its merits and demerits. It can be classified into two thereof: conventional circumcision (without devices) and shield and clamp devices. In systematic review of studies done in East and Central Africa, traditional circumcision could result in complications like wound infection, incomplete circumcision requiring re-circumcision and delayed wound healing. WHO recommends open type of conventional surgeries which includes dorsal slit, sleeve resection, use of forceps for guidance and amputation is done. this study was conducted to compare between conventional dorsal slit and modified dorsal slit techniques. ultimate goal of any method of circumcision is that it should be safe and complication free. In terms of intraoperative bleeding, the modified dorsal slit technique have significantly less intraoperative blood loss. In terms of operating time, the conventional dorsal slit technique has significantly lesser time required for surgery. In terms of surgeons compliance from procedure, there was no any significant difference in both the methods. In terms of postoperative pain, the modified dorsal slit with excision of prepuce technique have significantly less postoperative pain and in terms of cosmetic outcome from procedure, there was no any significant difference in both the methods. The modified dorsal slit with excision of prepuce method has advantage of significantly lower blood loss in surgery and significantly less postoperative pain may be due to less rough handling of tissue. There was no any significant difference in both the methods in terms of operating surgeons compliance with procedure, incidents of postoperative bleeding, postoperative urinary retention, postoperative local site oedema and infection rate. We thus recommend modified dorsal slit and excision method for management of circumcision in all cases undergoing circumcision by open method.