Effective penile block for circumcision in adults.

Area of Science:

• Urology
• Anesthesiology
• Surgical Procedures

Background:

• The dorsal nerve block for penile anesthesia during circumcision lacks standardization, leading to variable effectiveness.
• Assessing optimal techniques for blocking penile sensory innervation is crucial for patient comfort.

Purpose of the Study:

• To compare the efficacy of three different local anesthesia techniques for penile circumcision.
• To determine the most suitable method for blocking sensory nerves of the penis.

Main Methods:

• A prospective study randomized 89 adult men undergoing circumcision into three groups.
• Techniques included circular infiltration, circular plus dorsal penile infiltration, and circular plus ventral upward penile infiltration.
• Pinprick sensory testing and procedure duration were recorded to evaluate anesthesia effectiveness.

Main Results:

• The circular plus ventral upward infiltration group showed a significantly shorter average operation time.
• Penile sensation, particularly around the frenulum, was most effectively blocked in the ventral upward group, with 0% sensitivity by the fifth minute.
• This technique demonstrated superior and rapid sensory blockade compared to the other two methods.

Conclusions:

• Circular plus ventral upward anesthesia is a simple and practical technique for local anesthesia during circumcision.
• This method provides effective and rapid penile anesthesia, improving the circumcision procedure.