Effects of Intraoperative Tourniquet Use on Recovery Following Circumcision: A Randomised Controlled Study

Abstract

Abstract Objective To evaluate the safety and efficacy of intraoperative tourniquets when performing a circumcision using a disposable circumcision stapler. Methods 251 male patients; Mean age: 29.2 years, patients with excessively long prepuce and/or phimosis were enrolled in a randomized clinical trial between July 2019 and August 2020. Patients were divided into two groups: group A received Huitai annulus suture device (n = 111), and group B received Huitai annulus suture device with intraoperative tourniquet (n = 140). Operative time, intraoperative and postoperative pain, intraoperative and postoperative bleeding, postoperative complications, wound healing time, penis appearance and sexual satisfaction were measured. Results The intraoperative and postoperative bleeding in group A was more serious (4.432 ± 1.384 ml) than that in group B (1.879 ± 1.019 ml). In particular, 1 case in group A had incision fracture due to postoperative active bleeding and was returned to hospital for surgical suture to stop bleeding. Moreover, we found that the degree of swelling of the disposable circumcision suture device in group B was reduced after the tourniquet was applied (group A and group B: 18.41 ± 3.152 vs 16.69 ± 3.047), and there was no significant difference in postoperative pain score 7 days after surgery between group A and Group B: 3.054 ± 1.197 vs 2.993 ± 1.190), the postoperative infection rate was lower (group A and group B: 3.60% vs 1.43%), and there was no significant difference in sexual life between group A and group B: 0.8018 ± 0.4005 vs 0.8429 ± 0.3652). Conclusion There are differences in postoperative and intraoperative complications of tourniquet in disposable circumcision suture device. There was less risk of intraoperative bleeding, less risk of postoperative hematoma, earlier removal of nails, a more satisfactory appearance of recovery, and no significant difference in the risk of postoperative pain and post-operative infection. Transient ischemia after tourniquet had no effect on postoperative sexual life.