psd-502 and Genital-Diseases--Male

Surgical procedures used to remove genital warts (cryotherapy, electrodesiccation) are painful. Attempts to reduce the discomfort of surgery by prior lidocaine infiltration anesthesia are compromised by the pain of the infiltration.. Our purpose was to determine the efficacy of topically applied lidocaine/prilocaine cream to reduce the pain of lidocaine infiltration and the pain associated with cryotherapy to remove genital warts.. Men, scheduled for removal of genital warts by cryotherapy, were randomly selected to receive one of three treatments: (1) lidocaine/prilocaine cream application, (2) 1% lidocaine infiltration, and (3) lidocaine/prilocaine cream application followed by infiltration of 1% lidocaine.. Application of lidocaine/prilocaine cream for 15 minutes markedly reduced the pain of lidocaine infiltration. The combination of lidocaine/prilocaine cream followed by infiltration of 1% lidocaine gave greater pain relief from the cryotherapy than did either anesthetic alone.. The application of lidocaine/prilocaine cream as an adjunct to lidocaine infiltration reduced the pain of infiltration and the pain associated with cryotherapy for the removal of genital warts.

Topics: Anesthesia, Local; Anesthetics, Combined; Anesthetics, Local; Condylomata Acuminata; Cryotherapy; Drug Combinations; Genital Diseases, Male; Humans; Lidocaine; Lidocaine, Prilocaine Drug Combination; Male; Ointments; Pain Measurement; Prilocaine

To compare analgesic efficacy and pain caused by administration of lidocaine/prilocaine cream (EMLA(R)) versus xylocaine 1% local infiltration for punch biopsy and electrocoagulation of genital warts in men.. Open randomised comparative parallel-group study.. Department of Dermatovenereology, University Hospital Rotterdam/Dijkzigt, the Netherlands.. 63 males with warts on the genital mucosa and/or perianal area.. EMLA(R) cream (2.5-5 g) was applied during 13-45 minutes before surgery. Xylocaine 1% (0.1-4 ml) was infiltrated 0.5-4 minutes before surgery. Pain during administration and surgery was assessed by the patient on a verbal rating scale and on a visual analogue scale.. EMLA(R) application was painless in all patients (n = 31) whereas xylocaine infiltration was slightly painful in 17/29 patients and moderately painful in 10/29 patients. EMLA(R) analgesia was satisfactory for 94% of biopsies and 62% of electrocoagulations. Xylocaine infiltration was satisfactory in all procedures.. EMLA(R) application on the male genital mucosa is painless but it has a lower analgesic efficacy than xylocaine infiltration. However EMLA is a useful anaesthetic for taking biopsies in this area and may be used as premedication for local infiltration.

Topics: Adolescent; Adult; Aged; Anesthesia, Local; Anesthetics, Local; Biopsy; Drug Combinations; Electrocoagulation; Genital Diseases, Male; Humans; Lidocaine; Lidocaine, Prilocaine Drug Combination; Male; Middle Aged; Pain Measurement; Prilocaine; Warts

Removal of genital warts by thermocautery was performed in 108 patients (57 men and 51 women) under topical anaesthesia with a local anaesthetic cream, lidocaine and prilocaine (EMLA). Most men had warts in the preputial cavity, most women had warts situated on the mucous membranes of the vulva, and warts at multiple sites were common. About 1 ml of cream per lesion was applied to the warts for 20 to 105 minutes before the operation. Plastic film (Glad, Union Carbide) was applied over the cream when natural occlusion, such as under the prepuce or on the introitus, was not present. Local pallor was seen in 30% of the patients, redness in 53%, and oedema in 15%, but did not cause any discomfort and were clinically insignificant. Analgesia was sufficient in 96% of the men and in 40% of the women. Additional local infiltration was given to 60% of the women, but was not as painful as injections generally are in the genital area. The analgesic efficacy on women may be further improved by optimising the application time on the genital mucosa.

Topics: Adolescent; Adult; Anesthesia, Local; Anesthetics, Local; Cautery; Clinical Trials as Topic; Drug Combinations; Female; Genital Diseases, Female; Genital Diseases, Male; Humans; Lidocaine; Lidocaine, Prilocaine Drug Combination; Male; Middle Aged; Prilocaine; Warts