TITLE:
Post-Procedure Care Outweighs Device Factors in Determining Clinical Outcomes of Super Ring Circumcision in Indonesia: A Multicenter Retrospective Study
AUTHORS:
Heryyanoor, Riza Mazidu Sholihin, Andri Suwarno, Maulana Muhammad Hisyam, Annisa Febriana
KEYWORDS:
Circumcision, Super Ring, Wound Healing, Postoperative Care, Edema
JOURNAL NAME:
Open Journal of Urology,
Vol.16 No.6,
June
24,
2026
ABSTRACT: Introduction: Device-based circumcision techniques, including the super-ring method, have gained increasing acceptance because of their procedural simplicity and potential clinical benefits. However, variability in clinical outcomes persists, and the role of postprocedural care remains underexplored. Methods: This multicenter retrospective study analyzed 321 eligible medical records selected from 436 pediatric patients who underwent super-ring circumcision across 20 circumcision centers in Indonesia. The independent variables included procedural factors and postprocedural care practices. The outcomes were wound healing, time to ring detachment (≤10 vs. >10 days), and edema. Data were analyzed using the chi-squared test and multivariate logistic regression. Results: Most patients achieved complete wound healing (83.2%) and 59.8% experienced ring detachment within 10 days. Ointment use was the strongest predictor of wound healing (odds ratio [OR], 10.65; 95% confidence interval [CI], 4.56 - 24.90; p Conclusion: Post-procedural care factors, particularly ointment application and soaking practices, were more strongly associated with clinical outcomes than device-related factors in super-ring circumcision. These findings support the potential importance of standardized aftercare protocols in optimizing healing and reducing postoperative complications.