Novel Hydrodissection Circumcision: Preserving Subcutaneous Neurovascular Lymphatic Network and Accelerating Rehabilitation

Background: Conventional Circumcision (CC) is often associated with complications and appearance problem. Hydrodissection circumcision（HC）, a novel approach utilizing saline to separate tissue planes, may offer improved outcomes. Objective: To compare the efficacy, safety, and patient satisfaction of HC with CC. Design, Setting, and Participants: Over a period of more than 3 years (January 2021 to February 2024), 96 males (aged 6-35 years; average 12.3 years) who underwent circumcision were randomly divided into three groups: HC, sCC (tissue sparing), and uCC (tissue unsparing), with a follow-up period exceeding 1 year. Intervention: The HC group used physiological saline containing 0.5% lidocaine for hydrodissection, while the CC group did not have a hydrodissection step. Outcome Measurements and StatisticalAnalysis: Primary outcomes: operation time, intraoperative bleeding, postoperative pain and wound healing time. Secondary outcomes: intraoperative pain, postoperative complications and cosmetic results. The statistical analysis of results follows the single center retrospective analysis method. Results and Limitations: Compared with sCC, HC mainly reduced the operation time, intraoperative bleedingand postoperative pain scores (P<0.01). Compared with uCC, HC mainly reduced the wound healing time, intraoperative bleeding and postoperative pain scores (P<0.01). The complications of HC are rare, and patients are comparable satisfied with the appearance. The limitations lie in its single-center nature and small sample size. Conclusions: HC is superior to CC in reducing the operation time and improving recovery. Patient Summary: Hydrodissection circumcision is a safe and effective technique that improves surgical outcomes, offering a promising alternative to conventional methods.