Improving patient satisfaction and anatomical fit: a retrospective study on the purse-string suture-assisted disposable circumcision suture device.

Background: The disposable circumcision suture device (DCSD) faces significant limitations in anatomical adaptability. We developed a novel technique integrating the adjustable purse-string suture (APSS) from proctology to address this unmet need. This study aimed to evaluate the safety and feasibility of APSS-DCSD for circumcision.

Methods: A retrospective cohort study analyzed 93 consecutive patients undergoing circumcision (December 2023-January 2025). Non-randomized allocation stratified patients into: the APSS-DCSD cohort (n=45) and conventional DCSD cohort (n=48). Outcomes measure included operative time, blood loss, complications (frenular injury, infection), intraoperative pain (Visual Analogue Scale, VAS), patient satisfaction, and healing time.

Results: No significant intergroup differences were observed in blood loss (median: 3.2 vs. 3.1 mL; P=0.66), healing time (median: 24 vs. 23 days; P=0.85), or VAS scores (median: 3.0 vs. 4.0; P=0.10). The APSS-DCSD cohort revealed longer operative times [7.0 vs. 6.5 min; 95% confidence interval (CI): 1.708-8.809; P<0.001] and significantly higher satisfaction (median score: 5 vs. 4; 95% CI: 3.414-20.995; P<0.001). Incision infections occurred in three cases overall (APSS-DCSD: 2.2% vs. DCSD: 4.2%; P>0.99). No severe complications (hematoma, frenular injury) were documented in either cohort.

Conclusions: The APSS-DCSD approach significantly improves anatomical precision and patient satisfaction without compromising safety margins. Its standardized protocol demonstrates particular utility in complex anatomies, warranting prospective multicenter validation.