Comparison of Holmium: YAG laser circumcision with conventional circumcision in adult male

Abstract

Purpose: To evaluate the use of the Holmium: Yttrium-aluminum-garnet (YAG) laser versus the conventional dorsal-slit procedure for adult male circumcision. Materials and Methods: From January 2020 to December 2020, 60 adult men diagnosed with as having phimosis and received circumcision were enrolled. Patients received either Holmium: YAG laser circumcision or conventional circumcision. In this study, we assessed the difference between the groups. Results: Although the operative time and blood loss decreased more in the Holmium: YAG laser circumcision group than in the conventional circumcision group (P < 0.001), a longer short-term delay in wound healing was observed in the laser circumcision group than in the conventional circumcision during the follow-up course (20.0% vs. 3.3%, P = 0.04). Our results also demonstrated no significant difference between the two groups in pain control, postoperative prepuce edema, prepuce redundancy, infection, or hematoma occurrence (P > 0.05). Microscopy findings of the resected prepuce in the Holmium: YAG laser circumcision group demonstrated a high percentage of coagulated small capillaries near the cutting edge. Conclusion: The holmium laser seems to be a concrete and feasible option for circumcision. Although patients undergoing holmium laser circumcision benefit from less blood loss and a rapid surgery compared to the conventional procedure, there is a higher risk of poor wound healing in short-term follow-up.