Risk-dependent decision-making for circumcision in penile corporoplasty: type-2 diabetes mellitus associated with post-surgical phimosis.

Abstract

Introduction: Corporoplasty is typically accompanied by circumcision to prevent complications such as phimosis, foreskin edema, and necrosis, yet supporting evidence is limited. We reassessed the need for concomitant circumcision by quantifying postoperative phimosis and exploring associated comorbidities.

Methods: In this single-centre retrospective cohort study, 69 of 191 men who underwent corporoplasty between 2010 and 2023 met predefined criteria. Patients with incomplete records, refusal to participate, or loss to follow-up were excluded. Data collection involved the administration of a questionnaire to patients, supplemented by data retrieved from medical databases. The median age was 55 years (range 17-70 years).

Results: 48 of 69 patients did not undergo circumcision either before or during the corporoplasty. Only 3 out of the 48 patients (6.25%) developed post-surgical phimosis. No post-surgical foreskin necrosis were reported. A relevant finding was type2 diabetes mellitus as a significant risk factor for post-surgical phimosis (p < 0.0038). Additionally, the negative impact of the degree of curvature on post-surgical glans penis sensitivity was identified (p = 0.027).

Conclusion: Our findings advocate against the obligatory practice of circumcision performing corporoplasty. Nonetheless, our results emphasize the importance of counseling patients with type2 diabetes mellitus due to their heightened susceptibility to post-surgical phimosis development.