Comparative Study of Effectiveness of Bipolar Electrocautery Versus Standard Freehand Scalpel Usage in Adult Circumcision Procedure – Prospective Randomized Controlled Trial

Abstract

Background: Adult circumcision is a commonly performed surgical procedure indicated for phimosis, recurrent balanitis, paraphimosis, and elective reasons. Conventional scalpel technique remains widely practiced; however, bipolar electrocautery has gained popularity due to improved hemostasis and operative efficiency.

Objective: The present study aimed to evaluate the effectiveness of bipolar electrocautery scissors compared with the conventional standard freehand scalpel technique in adult circumcision, with specific assessment of operative time, intraoperative blood loss, postoperative pain, postoperative complications, and wound healing outcomes.

Materials and Methods: A prospective randomized controlled trial was conducted among 50 adult males undergoing circumcision. Patients were divided into two groups: Group A (scalpel technique, n=25) and Group B (Bipolar Electrocautery, n=25). Operative time, intraoperative blood loss, postoperative pain (VAS score), complications, and healing time were recorded. Statistical analysis was performed using independent t-test for continuous variables and Pearson’s Chi-square test for categorical variables. p < 0.05 was considered significant.

Results: Mean operative time was significantly lower in the bipolar group (18.4 ± 3.2 min) compared to the scalpel group (26.7 ± 4.5 min) (p < 0.001). Mean blood loss was significantly reduced in the bipolar group (12.6 ± 4.1 mL vs 32.8 ± 6.7 mL; p < 0.001). Postoperative pain scores were lower in the bipolar group on Day 1 (3.1 ± 0.8 vs 4.6 ± 1.1; p < 0.001). Complication rates were comparable (p > 0.05).

Conclusion: Bipolar electrocautery circumcision significantly reduces operative time and blood loss with comparable complication rates, making it a safe and efficient alternative to the scalpel technique.

Keywords: Adult circumcision, bipolar electrocautery, freehand scalpel technique, randomized controlled trial, operative time, complications