Abstract
We presented a novel circumcision technique for adult phimosis that combines the advantages of three circumcision methods-dorsal slit, guillotine, and sleeve (DGS)-while modifying technical details, referred to as the modified DGS technique. This retrospective comparative trial enrolled 483 adult males with phimosis undergoing circumcision between March 1, 2018 and March 1, 2024 at our hospital. The patients were divided into the modified DGS technique group (n = 151) and control (dorsal slit technique) group (n = 332) according to their preferences. Postoperative complications, surgical duration, and satisfaction with penile appearance were compared. The overall complication rate was 2.6% in the modified DGS group and 11.1% in the control group (p = 0.0019). The mean surgical duration was 36.8 ± 11.5 min for the modified DGS group and 35.2 ± 8.9 min for the control group (p = 0.0964). The modified DGS group exhibited a significantly lower dissatisfaction rate regarding overall penile appearance compared to the control group (2.6% versus 18.1%, p < 0.0001) as assessed by the postoperative follow-up questionnaire. The modified DGS technique, compared with the dorsal slit approach, can be used for phimosis with a similar surgical duration. It demonstrates fewer complications and better cosmetic outcomes.