psd-502 and Penile-Diseases

We report what we think is the first case of localised angioedema of the glans penis as a result of contact allergy to prilocaine in EMLAP cream. We also propose a new term, contact angioedema for this condition.

Topics: Anesthetics, Local; Angioedema; Humans; Lidocaine; Lidocaine, Prilocaine Drug Combination; Male; Middle Aged; Penile Diseases; Prilocaine

A number of minor urological surgical procedures can be readily carried out in children in outpatient clinics with the availability of a good topical local anaesthetic. In boys, the separation of preputial adhesions, frenulotomy, meatoplasty, meatal dilatation following circumcision or meatal surgery, the removal of smegma and excision of penile skin lesions can be performed as outpatient treatment. In girls, hymenal abnormalities, meatal abnormalities and labial adhesions come into consideration for its use. Success is dependent on a good estimation of the mental capacity of the child to undergo a local surgical procedure and correct use of the anaesthetic.

Topics: Ambulatory Surgical Procedures; Anesthetics, Combined; Anesthetics, Local; Child; Child Development; Child, Preschool; Circumcision, Male; Dilatation, Pathologic; Female; Humans; Hymen; Lidocaine; Lidocaine, Prilocaine Drug Combination; Male; Minor Surgical Procedures; Ointments; Penile Diseases; Prilocaine; Smegma; Tissue Adhesions; Treatment Outcome; Urethra; Urethral Diseases; Urethral Stricture; Urologic Surgical Procedures; Vulvar Diseases

To see if a eutectic mixture of local anaesthetics (EMLA) could be used effectively for the release of preputial adhesions as a day case procedure.. A total of 36 consecutive symptomatic children had their preputial adhesions separated under local anaesthetic with EMLA.. The procedure was successful in 27 children. Of these, 16 remained symptom free at 9 to 12 months follow up although five children had slight recurrence of adhesions. The other 11 children were listed for circumcision at 2 weeks following the procedure because of marked recurrence of adhesions.. EMLA cream is a good alternative to general anaesthetics in the separation of preputial adhesions. The technique is operator-dependent and better results were obtained when one person was using it regularly. Separation of adhesions is a worthwhile procedure in boys with symptomatic non-retractile foreskins.

Topics: Anesthetics, Local; Child; Child, Preschool; Circumcision, Male; Drug Combinations; Follow-Up Studies; Humans; Lidocaine; Lidocaine, Prilocaine Drug Combination; Male; Ointments; Penile Diseases; Penis; Prilocaine; Recurrence; Reoperation; Tissue Adhesions

One hundred consecutive cases of boys with foreskin problems referred to local paediatric surgeons in the Edinburgh area were studied. Fifty five underwent circumcision and the remainder were managed more conservatively with or without the use of local or general anaesthetic. Although sometimes avoiding general anaesthetic, the more conservative methods involved more frequent visits to the clinic, a larger number of complications, and a longer follow up period. Despite the vogue for conservatism, circumcision still has an important part to play in the management of troublesome foreskins in children.

Topics: Anesthetics, Local; Child; Circumcision, Male; Drug Combinations; Humans; Lidocaine; Lidocaine, Prilocaine Drug Combination; Male; Penile Diseases; Phimosis; Physical Therapy Modalities; Prilocaine; Prospective Studies; Tissue Adhesions

In most boys referred for circumcision preputial adhesions are the only problem, but these can predispose to recurrent balanitis. A simple technique using Emla cream (eutectic mixture of lignocaine and prilocaine) has been devised which allows the adhesions to be separated painlessly in the outpatient clinic. The technique was used on 39 boys aged 2 to 12 years referred for circumcision, none of whom had a retractable foreskin. The cream was applied under an occlusive dressing and left for 60 minutes before the adhesions were separated with a probe and a gauze swab. The procedure was completely pain free in 32 boys. One boy had to undergo a repeated procedure because he failed to follow the advice regularly to retract his foreskin in the three weeks after the procedure. Only one boy had to undergo circumcision later because of fibrous phimosis. In many boys referred for circumcision separation of preputial adhesions is all that is needed, and the use of this local anaesthetic technique avoids the need for general anaesthesia.

Topics: Ambulatory Surgical Procedures; Anesthetics, Local; Child; Child, Preschool; Circumcision, Male; Drug Combinations; Humans; Lidocaine; Lidocaine, Prilocaine Drug Combination; Male; Penile Diseases; Prilocaine; Tissue Adhesions