What's the Difference Between Sleeve Resection and Dorsal Slit in Circumcision?
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Circumcision procedures have been around for centuries as a health choice, as surgery can significantly reduce several risks. Here are some of the risks you’ll avoid by undergoing circumcision:
Improve hygiene: Uncircumcised men sometimes find maintaining hygiene challenging. Circumcision helps avoid the build-up of bacteria under the foreskin.
Prevent phimosis: Uncircumcised adult males may experience penile problems like phimosis or difficulty retracting the foreskin. Phimosis can lead to inflammation of the foreskin or glans penis.
Decrease risk of urinary tract infections: Uncircumcised men tend to have a higher risk of contracting urinary infections—even though the overall risk in men is low. Circumcision helps reduce the risk of urinary tract infections and, subsequently, kidney problems as well.
Now, there are several different methods of circumcision surgery, each with its own benefits and disadvantages. The two common techniques for adult circumcision are the sleeve resection technique and the dorsal slit technique.
In this article, we’ll discuss the difference between these two procedures in detail to help you decide which you prefer when undergoing circumcision.
What is the Sleeve Resection Method?
The sleeve resection method is a freehand circumcision technique that’s suitable for infants and adults. The technique is often used in adult circumcision, as it provides better cosmetic results than a dorsal slit.
In a nutshell, the sleeve resection method involves incisions with a scalpel on the outer and mucosal surfaces of the foreskin. Doing so allows doctors to perform the whole procedure within an hour. The sleeve resection method is performed under local anesthesia.
Sleeve Resection Procedure
Here’s how a doctor carries out the circumcision procedure with this type of circumcision:
First, the doctor slides the prepuce over the head of the penis and creates a freehand cut around the penis shaft to place the scar line.
Then, the foreskin is brought back to cover the glans, and the doctor creates another circumferential incision around the shaft at the same position as the first cut.
The doctor cuts vertically between the two circumferential cuts and then removes the strip of skin.
Lastly, the doctor pulls together the free raw edges and applies an absorbable suture.
Pros and Cons of Sleeve Resection Circumcision
ProsConsVersatility Doctors can use the method even with patients who experience severe phimosis, balanitis, or frenulum breve. Higher Risk for Some Patients It can be a dangerous method for patients with pre-existing medical conditions (e.g., diabetes and hypertension).Precision The method is known as one of the most precise methods, resulting in better cosmetic results. Higher Complexity It’s a complex procedure, so there’s the risk of experiencing penile injury and infection. Less Blood Loss Compared to other methods, the sleeve reduction method tends to result in less blood loss. Risk of Excess Foreskin The procedure may not result in the total removal of the foreskin, which leads to more problems.
If you need more information, read our in-depth blog on the sleeve resection method.
What Is the Dorsal Slit Circumcision Method?
The dorsal slit circumcision technique involves cutting a vertical incision along the top side of the penis to expose the glans of the penis and remove the foreskin. The dorsal slit is a common method for infants and children with an intact prepuce and is performed under local anesthesia.
Doctors commonly use the method to relieve the tightness of the penis when the patient has difficulty retracting the foreskin, like in cases of penile injuries, which would lead to phimosis and paraphimosis.
Dorsal Slit Circumcision Procedure
Here’s how the doctor carries out the circumcision procedure:
The doctor cuts vertically from the base of the penis, extending to the top.
Then, the doctor crushes and divides the inner and outer preputial layers, extending to the corona to completely free the prepuce under direct vision.
After these cuts, the incision is closed by opposing edges in the horizontal plane.
The doctor places dissolvable sutures between the two remaining edges.
Pros and Cons of Dorsal Slit Circumcision
ProsConsTreatment for Phimosis and Paraphimosis The approach gives doctors more access to the inner foreskin, making it the ideal technique for treating infections.
Possible Injuries Patients may experience injury to the urethra or glans. However, the risk is low when performed using proper techniques.
Identification and Treatment of Injuries A dorsal slit allows for more direct vision of the surgical area, so it’s easy to identify and address any injuries during the surgery
More Blood Loss The procedure is performed on the top side of the penis, so there’s a chance of excessive bleeding. Doctors can decrease bleeding by correctly placing stitches after the incision
Avoid Procedural Hemorrhaging The crushing of the preputial skin that happens during the procedure helps reduce the risk of hemorrhage when cutting the foreskin.
Possible Wound Infections Postoperative complications include wound infections if the patient doesn’t follow proper aftercare.
Read more about how to ensure proper circumcision aftercare here.
Sleeve Resection vs. Dorsal Slit Circumcision
Both sleeve resection and dorsal slit circumcision methods are safe techniques suitable for adult circumcision and generally provide good cosmetic results.
Doctors typically use the dorsal slit circumcision technique in emergencies for patients suffering from phimosis and paraphimosis. That’s because it’s the easiest and fastest way to relieve strangulation pressure from paraphimosis and allow better visuals of the urethral meatus from phimosis.
The sleeve resection method is also preferred by adults because it provides better cosmetic results than the dorsal slit technique. It is also a better option to treat foreskin problems like recurrent balanitis, frenulum breve, BXO, penile cancer, and circumcision revision.
Which Is the Best Technique For You?
Circumcision is a surgical procedure, so it’s best to consult with qualified doctors to learn more about its risks and benefits. They can advise you on which technique is the best for you.
Whether you choose the dorsal slit or sleeve resection, the ultimate goal is to perform it properly without complications and to ensure that you don’t risk serious penile injuries during the operation. you should only allow highly-skilled surgeons to perform your circumcision procedure.
The Center for Circumcision’s highly-skilled and board-certified surgeons are happy to discuss your options with you and help you make a safe and informed decision for your circumcision.
Schedule a free consultation with us to learn more about safe and professional adult circumcision. Contact us today!