Comparison of novel dorsal buttonhole slit versus conventional dorsal slit circumcision: efficacy, safety, and parents' satisfaction.

Abstract

Introduction and objective: Circumcision is the most frequently performed surgical procedure worldwide. The World Health Organization recommends that circumcisions be performed by dorsal slit incision. This study introduces the dorsal buttonhole slit, a novel modification of the conventional dorsal slit technique, and aims to evaluate its clinical outcomes and safety in a pediatric cohort.

Materials and methods: This retrospective descriptive study was conducted on 107 pediatric patients aged 1-10 years who underwent circumcision for religious reasons or phimosis between January 2022 and December 2023. Patients were divided into two groups based on the surgical technique used: dorsal buttonhole slit (n=56) vs conventional dorsal slit (n=51). The assessment parameters included intra-operative hemorrhage, operating time, healing time, postoperative complications, and parental satisfaction.

Results: The mean operative time was significantly shorter in the dorsal buttonhole slit group compared to the conventional group (293.79 vs 320.67 seconds, respectively; p=0.028). There was no significant difference in wound healing time between the two groups. No postoperative complications, such as hemorrhage or need for revision, were observed in any patient during the 1-month follow-up period. All parents reported satisfaction with the functional and cosmetic results.

Conclusions: The dorsal buttonhole slit technique was associated with a shorter operative time and excellent safety outcomes. While these results are promising, prospective randomized trials are required to definitively confirm the efficacy and safety of this method. The technique shows potential as a reproducible and reliable alternative for pediatric circumcision.