psd-502 and Phimosis

In the United States, the treatment of choice for the correction of phimosis is circumcision, whereas in European countries, the condition is usually treated by preputial plasty using Duhamel's method or modified versions. We report our experience in correcting phimosis by preputial plasty using transversal widening on the dorsal side with EMLA local anesthetic cream.. Twenty-six patients with phimosis were operated on by preputial plasty, under local anesthesia with EMLA cream. A transversal incision is made on the dorsal side of the ring of prepuce, like 3 contiguous Ts, the middle one inverted with the long arm on the preputial mucosa side. The 2 small mucocutaneous flaps of the prepuce are separated and then sutured with interrupted stitches, thus transforming the incisions from T to V.. No postoperative complications were observed. At 1-year follow-up, the cosmetic and functional results were satisfactory.. The technique of preputial plasty that the authors present enlarges the stenotic ring of prepuce by a transversal widening on the dorsal side. The ring of prepuce obtained is wide and symmetrical on its dorsal and ventral sides and therefore cosmetically and functionally satisfactory. It is a good alternative to the more radical circumcision technique.

Topics: Anesthetics, Local; Child; Child, Preschool; Humans; Lidocaine; Lidocaine, Prilocaine Drug Combination; Male; Penis; Phimosis; Prilocaine; Retrospective Studies; Surgical Flaps; Urologic Surgical Procedures, Male

The authors present their technique of local anaesthesia in the surgical treatment of phimosis using a cream composed of an eutectic mixture of lidocaine and prilocaine (Emla). This cream, unlike injectable local anaesthetics, allows surgical procedures to be performed on the prepuce without pain.

Topics: Adult; Anesthetics, Local; Child; Drug Combinations; Evaluation Studies as Topic; Humans; Lidocaine; Lidocaine, Prilocaine Drug Combination; Male; Ointments; Phimosis; Prilocaine

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