CO2 laser frenuloplasty for cryotherapy-induced frenulum perforation: a case report.

Abstract

Background: The penile frenulum is a sensitive tissue fold connecting the glans to the penile shaft, preventing excessive foreskin retraction during an erection. Susceptible to injuries from trauma or medical treatments, effective repair is crucial for restoring functionality and alleviating discomfort. Traditional frenulum repair typically involves scalpel surgery, but CO₂ laser frenuloplasty has emerged as an innovative alternative, offering enhanced precision and faster recovery. This study examines a case of frenulum perforation post-cryotherapy for condylomas, highlighting the use of CO₂ laser frenuloplasty and its outcomes.

Case description: A 25-year-old male experienced a frenulum perforation after aggressive cryotherapy for recurrent genital condylomas. This damage required effective treatment to restore functionality and relieve discomfort. The patient underwent CO₂ laser frenuloplasty, known for its precision in delicate tissues. The procedure, conducted in a single session with the laser set to 0.3-1 W and 10 Hz, involved local anesthesia with 0.5 mL of lidocaine. An incision in the median frenulum was made, dividing it into two parts, followed by vaporization of the proximal and distal ends using the laser. This minimized thermal damage and intraoperative bleeding, promoting quicker healing. Post-procedure, the patient exhibited localized inflammation and mild swelling but no significant bleeding. A topical healing gel with cicatrizing agents and topical antibiotics was prescribed. At the 1-month follow-up, the patient reported significant symptom improvement. Photographs showed well-healed tissue with minimal scarring, and the patient experienced no significant pain or functional limitations. The topical gel positively contributed to the healing process, preventing infection and supporting tissue regeneration.

Conclusions: CO₂ laser frenuloplasty offers several advantages over traditional scalpel surgery, including enhanced accuracy, reduced tissue trauma, minimal bleeding, and faster recovery. The laser's ability to coagulate blood vessels ensures a clearer surgical field and better hemostasis, while its sterilizing effect reduces post-operative infection risk. This case demonstrates the effectiveness of CO₂ laser frenuloplasty in treating frenulum damage, resulting in successful healing with minimal complications. Further studies with larger cohorts are recommended to confirm these findings and refine treatment protocols, highlighting the importance of precise surgical techniques and targeted post-operative care.