Laser microsurgery for superficial lesions of the penis

A carbon dioxide laser microsurgical technique for partial or complete resection of superficial lesions of the penis is described. This technique was used in 47 patients from January 1982 to May 1985. Of the 47 patients 32 (68 per cent) were treated on an outpatient basis. Histological study of the lesions showed microscopically invasive cancer in 8 patients, carcinoma in situ in 4, grades II and III dysplasia in 5, hyperkeratosis or parakeratosis in 10, pigmented lesions in 2, papilloma in 1 and no residual disease after systemic chemotherapy for exophytic carcinoma in 3. Laser surgery was performed in 1 stage under constant microscopic visual control. The depth of the resection ranged from 0.5 to 2.6 mm. (mean depth 1.5 mm.). Surgical specimens were fit for a correct pathological examination when they were thicker than 0.5 mm. (95.7 per cent of the cases). Microscopically, the margins of the resection resulted in healthy tissue in 41 of the 45 evaluable specimens (87.2 per cent). The mean distance between the lesion and incision borders was 0.6 mm. (range 0.4 to 1 mm.). Of the 4 patients with microscopic evidence of disease at the resected margins 3 underwent another laser microsurgical procedure and 1 received external beam radiation. Healing by secondary intention had an average duration of 6 weeks. Cosmetic results were satisfactory in every patient. Only 1 patient (2 per cent) suffered complications (arterial hemorrhage). In conclusion, the short-term results of this surgical technique for penile lesions are satisfactory. Further followup is needed to evaluate the curative potential of this method.