Bloodless, painless, suture less circumcision: A combination of diode laser with cyanoacrylate skin glue in patient with second grade of phimosis
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Apr 11, 2025
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Abstract
Circumcision is a common surgical operation that entails excising the foreskin from the penis, primarily to improve hygiene and prevent the accumulation of smegma. This practice is widely observed worldwide, especially within Muslim and Jewish populations. However, despite its advantages, circumcision may lead to several complications, such as excessive bleeding and infections. A healthy 13-year-old male presented for circumcision due to grade 2 phimosis, seeking to improve his personal hygiene. The procedure was executed using a combination of diode laser technology and cyanoacrylate skin glue, which minimized tissue trauma and provided effective wound closure. When circumcision is performed utilizing advanced methods such as diode laser and cyanoacrylate glue, it is regarded as a safe and effective intervention. This approach offers considerable benefits in terms of recovery duration, cosmetic results, and overall patient comfort, while also maintaining low rates of complications.
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How to Cite
Amsriza, F. R. and Fakhriani, R. (2025) “Bloodless, painless, suture less circumcision: A combination of diode laser with cyanoacrylate skin glue in patient with second grade of phimosis”, Science Midwifery, 13(1), pp. 214-220. doi: 10.35335/midwifery.v13i1.1901.
References
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Azmi, Y. A., Yogiswara, N., & Renaldo, J. (2022). The efficacy of tissue glue in pediatric circumcision wound approximation: A meta-analysis of randomized controlled trial. Journal of Pediatric Urology, 18(3), 327–333. https://doi.org/10.1016/j.jpurol.2022.03.010
Bernaschina-Rivera, S. A., López-Chaim, A. I., Cordero-Pacheco, J. A., Fernández-Crespo, R., Quesada-Olarte, J., & Carrión, R. (2023). Circumcision and Sexual Medicine. Sexual Medicine Reviews, 11(4), 412–420. https://doi.org/10.1093/sxmrev/qead009
Morris, B. J., Athos Katelaris, Norman J. Blumenthal, Mohamed Hajoona, Adrian C. Sheen, Leslie Schrieber, Eugenie R. Lumbers, Alex D. Wodak, & Phillip Katelaris. (2022). Evidence-based circumcision policy for Australia. Journal of Men’s Health, 18(6), 1. https://doi.org/10.31083/j.jomh1806132
Czajkowski, M., Czajkowska, K., Zarańska, K., Giemza, A., Kłącz, J., Sokołowska-Wojdyło, M., & Matuszewski, M. (2021). Male Circumcision Due to Phimosis as the Procedure That Is Not Only Relieving Clinical Symptoms of Phimosis But Also Improves the Quality of Sexual Life. Sexual Medicine, 9(2), 100315–100315. https://doi.org/10.1016/j.esxm.2020.100315
Dodero, D., Frascani, F., Angelucci, M., Bernabei, G., Merlo, E., Locatelli, F., Recalcati, D., & Murina, F. (2019). Histological Modifications of Postmenopausal Vaginal Mucosa after Regenerative Solid State Laser Treatment: A Multicenter Study. International Journal of Women’s Health and Wellness, 5(3). https://doi.org/10.23937/2474-1353/1510099
Daryanto, B., Satyagraha, P., Kustono, A., Dhani, F. K., Negara, E. P., Purnomo, A. F., Sholihah, N., & Hanggara, D. S. (2024). Factors Influencing Post-Circumcision Wound Healing. Indonesian Journal of Urology, 31(2). https://doi.org/10.32421/juri.v31i2.960
Dodero, D., Frascani, F., Angelucci, M., Bernabei, G., Merlo, E., Locatelli, F., & Murina, F. (2018). Solid State Vaginal Laser for the Treatment of Genitourinary Syndrome of Menopause: A Preliminary Report. Open Journal of Obstetrics and Gynecology, 08(02), 113–121. https://doi.org/10.4236/ojog.2018.82015
Fahmy, M. A. B. (2020). Phimosis. In Normal and Abnormal Prepuce (pp. 163–179). Springer International Publishing. https://doi.org/10.1007/978-3-030-37621-5_18
Falcão, B. P., Stegani, M., & Matias, J. E. F. (2018). Phimosis and Circumcision: Concepts, History, and Evolution. International Journal of Medical Reviews, 5(1), 6–18. https://doi.org/10.29252/IJMR-050103
Gorgulu, T., Olgun, A., Torun, M., & Kargi, E. (2016). A fast, easy circumcision procedure combining a CO2 laser and cyanoacrylate adhesive: a non-randomized comparative trial. International Braz j Urol, 42(1), 113–117. https://doi.org/10.1590/S1677-5538.IBJU.2015.0284
Kılıç, S. (2024). Comparative analysis of two methods in circumcision: a new disposable device versus classic sleeve technique. BMC Urology, 24(1), 126. https://doi.org/10.1186/s12894-024-01513-9
Li, K., Nicoli, F., Xi, W. J., Zhang, Z., Cui, C., Al-Mousawi, A., Balzani, A., Tong, Y., & Zhang, Y. (2019). The 1470 nm diode laser with an intralesional fiber device: a proposed solution for the treatment of inflamed and infected keloids. Burns & Trauma, 7. https://doi.org/10.1186/s41038-019-0143-6
Lovin, J. M., Stone, K. M., Pickett, J. K., & Kirsch, A. J. (2022). Sutureless circumcision using monopolar diathermy and 2-octyl cyanoacrylate is safe and effective in a cohort of 634 post-neonatal prepubescent boys. Journal of Pediatric Urology, 18(6), 790–795. https://doi.org/10.1016/j.jpurol.2022.03.014
Prabhakaran, S., Ljuhar, D., Coleman, R., & Nataraja, R. M. (2018). Circumcision in the paediatric patient: A review of indications, technique and complications. Journal of Paediatrics and Child Health, 54(12), 1299–1307. https://doi.org/10.1111/jpc.14206
Raveenthiran, V. (2018). The evolutionary saga of circumcision from a religious perspective. Journal of Pediatric Surgery, 53(7), 1440–1443. https://doi.org/10.1016/j.jpedsurg.2018.03.001
Ronchi, P., Scarcella, S., Manno, S., Beatrici, V., & Dell’Atti, L. (2022). Dual laser circumcision: a novel technique to improve traditional surgery. Laser Therapy, 29(2), 94–99. https://doi.org/10.4081/ltj.2022.295
Singh, P. K., Degala, S., Shetty, S., Rai, V. S., & Das, A. (2019). To Evaluate the Efficacy and Effectiveness of N-butyl-2-cyanoacrylate glue (TRU SEAL) in Closure of Oral and Maxillofacial Laceration and Surgical Incisions. Journal of Maxillofacial and Oral Surgery, 18(1), 131–138. https://doi.org/10.1007/s12663-018-1111-6
Surya, P. A., Putratama, A., Surya, R. N. H., & Ananda, G. Y. P. (2024). The Association of Circumcision and Genitourinary Cancer, Especially Penile Cancer and Prostate Cancer: A 30-Year Systematic Review and Meta-Analysis. Indonesian Journal of Cancer, 18(3), 354–361. https://doi.org/10.33371/ijoc.v18i3.1123
Warees, M. W., Sachit Anand, Stephen W. Leslie, & Alexander M. Rodriguez. (2025, January). Circumcision. StatPearls Publishing.
Zhang, X., Wang, X., Gao, C., Qin, J., Zhao, H., Li, W., & Lu, X. (2018). A 1470-nm laser combined with foam sclerotherapy in day surgery: a better choice for lower limb varicose veins. Lasers in Medical Science, 33(7), 1505–1511. https://doi.org/10.1007/s10103-018-2507-8
Aravind, K., Sunil, C. G., Chandrasekar, S., Shidlingappa, S. S., Kamat, V., Kulkarni, M., Balachandra, S. P., Chandran, A., & Vaidyanathan, R. (2024). Cyanoacrylate vs. sutures in clean and clean-contaminated surgical wounds – a randomised control study. Innovative Surgical Sciences, 9(1), 47–54. https://doi.org/10.1515/iss-2023-0060
Azmi, Y. A., Yogiswara, N., & Renaldo, J. (2022). The efficacy of tissue glue in pediatric circumcision wound approximation: A meta-analysis of randomized controlled trial. Journal of Pediatric Urology, 18(3), 327–333. https://doi.org/10.1016/j.jpurol.2022.03.010
Bernaschina-Rivera, S. A., López-Chaim, A. I., Cordero-Pacheco, J. A., Fernández-Crespo, R., Quesada-Olarte, J., & Carrión, R. (2023). Circumcision and Sexual Medicine. Sexual Medicine Reviews, 11(4), 412–420. https://doi.org/10.1093/sxmrev/qead009
Morris, B. J., Athos Katelaris, Norman J. Blumenthal, Mohamed Hajoona, Adrian C. Sheen, Leslie Schrieber, Eugenie R. Lumbers, Alex D. Wodak, & Phillip Katelaris. (2022). Evidence-based circumcision policy for Australia. Journal of Men’s Health, 18(6), 1. https://doi.org/10.31083/j.jomh1806132
Czajkowski, M., Czajkowska, K., Zarańska, K., Giemza, A., Kłącz, J., Sokołowska-Wojdyło, M., & Matuszewski, M. (2021). Male Circumcision Due to Phimosis as the Procedure That Is Not Only Relieving Clinical Symptoms of Phimosis But Also Improves the Quality of Sexual Life. Sexual Medicine, 9(2), 100315–100315. https://doi.org/10.1016/j.esxm.2020.100315
Dodero, D., Frascani, F., Angelucci, M., Bernabei, G., Merlo, E., Locatelli, F., Recalcati, D., & Murina, F. (2019). Histological Modifications of Postmenopausal Vaginal Mucosa after Regenerative Solid State Laser Treatment: A Multicenter Study. International Journal of Women’s Health and Wellness, 5(3). https://doi.org/10.23937/2474-1353/1510099
Daryanto, B., Satyagraha, P., Kustono, A., Dhani, F. K., Negara, E. P., Purnomo, A. F., Sholihah, N., & Hanggara, D. S. (2024). Factors Influencing Post-Circumcision Wound Healing. Indonesian Journal of Urology, 31(2). https://doi.org/10.32421/juri.v31i2.960
Dodero, D., Frascani, F., Angelucci, M., Bernabei, G., Merlo, E., Locatelli, F., & Murina, F. (2018). Solid State Vaginal Laser for the Treatment of Genitourinary Syndrome of Menopause: A Preliminary Report. Open Journal of Obstetrics and Gynecology, 08(02), 113–121. https://doi.org/10.4236/ojog.2018.82015
Fahmy, M. A. B. (2020). Phimosis. In Normal and Abnormal Prepuce (pp. 163–179). Springer International Publishing. https://doi.org/10.1007/978-3-030-37621-5_18
Falcão, B. P., Stegani, M., & Matias, J. E. F. (2018). Phimosis and Circumcision: Concepts, History, and Evolution. International Journal of Medical Reviews, 5(1), 6–18. https://doi.org/10.29252/IJMR-050103
Gorgulu, T., Olgun, A., Torun, M., & Kargi, E. (2016). A fast, easy circumcision procedure combining a CO2 laser and cyanoacrylate adhesive: a non-randomized comparative trial. International Braz j Urol, 42(1), 113–117. https://doi.org/10.1590/S1677-5538.IBJU.2015.0284
Kılıç, S. (2024). Comparative analysis of two methods in circumcision: a new disposable device versus classic sleeve technique. BMC Urology, 24(1), 126. https://doi.org/10.1186/s12894-024-01513-9
Li, K., Nicoli, F., Xi, W. J., Zhang, Z., Cui, C., Al-Mousawi, A., Balzani, A., Tong, Y., & Zhang, Y. (2019). The 1470 nm diode laser with an intralesional fiber device: a proposed solution for the treatment of inflamed and infected keloids. Burns & Trauma, 7. https://doi.org/10.1186/s41038-019-0143-6
Lovin, J. M., Stone, K. M., Pickett, J. K., & Kirsch, A. J. (2022). Sutureless circumcision using monopolar diathermy and 2-octyl cyanoacrylate is safe and effective in a cohort of 634 post-neonatal prepubescent boys. Journal of Pediatric Urology, 18(6), 790–795. https://doi.org/10.1016/j.jpurol.2022.03.014
Prabhakaran, S., Ljuhar, D., Coleman, R., & Nataraja, R. M. (2018). Circumcision in the paediatric patient: A review of indications, technique and complications. Journal of Paediatrics and Child Health, 54(12), 1299–1307. https://doi.org/10.1111/jpc.14206
Raveenthiran, V. (2018). The evolutionary saga of circumcision from a religious perspective. Journal of Pediatric Surgery, 53(7), 1440–1443. https://doi.org/10.1016/j.jpedsurg.2018.03.001
Ronchi, P., Scarcella, S., Manno, S., Beatrici, V., & Dell’Atti, L. (2022). Dual laser circumcision: a novel technique to improve traditional surgery. Laser Therapy, 29(2), 94–99. https://doi.org/10.4081/ltj.2022.295
Singh, P. K., Degala, S., Shetty, S., Rai, V. S., & Das, A. (2019). To Evaluate the Efficacy and Effectiveness of N-butyl-2-cyanoacrylate glue (TRU SEAL) in Closure of Oral and Maxillofacial Laceration and Surgical Incisions. Journal of Maxillofacial and Oral Surgery, 18(1), 131–138. https://doi.org/10.1007/s12663-018-1111-6
Surya, P. A., Putratama, A., Surya, R. N. H., & Ananda, G. Y. P. (2024). The Association of Circumcision and Genitourinary Cancer, Especially Penile Cancer and Prostate Cancer: A 30-Year Systematic Review and Meta-Analysis. Indonesian Journal of Cancer, 18(3), 354–361. https://doi.org/10.33371/ijoc.v18i3.1123
Warees, M. W., Sachit Anand, Stephen W. Leslie, & Alexander M. Rodriguez. (2025, January). Circumcision. StatPearls Publishing.
Zhang, X., Wang, X., Gao, C., Qin, J., Zhao, H., Li, W., & Lu, X. (2018). A 1470-nm laser combined with foam sclerotherapy in day surgery: a better choice for lower limb varicose veins. Lasers in Medical Science, 33(7), 1505–1511. https://doi.org/10.1007/s10103-018-2507-8