Caudal anaesthesia as a treatment for penile ischaemia following circumcision

We report an ischaemic penile glans following circumcision and a dorsal penile nerve block in a 9-year-old boy. Ischaemia of the glans penis is a rare complication associated independently with both circumcision and dorsal penile nerve blocks. There are a number of pathophysiological mechanisms of this ischaemia and its management is varied and not well recorded. We report the successful management of this complication using a caudal epidural block and also discuss technical aspects of penile nerve blocks.