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Meatotomy using topical anesthesia: A painless option
Vinod Priyadarshi1, Anurag Puri1, Jitendra Pratap Singh1
1Department of Urology, IPGMER and SSKM Hospital, Kolkata, West Bengal, India.
Urology Annals
|February 7, 2015
Summary
Topical anesthesia with eutectic mixture of prilocaine and lidocaine (EMLA/Prilox) cream effectively reduced pain during urethral meatotomy, avoiding painful injections and associated anxiety for patients.
Area of Science:
- Urology
- Anesthesiology
Background:
- Urethral meatotomy is commonly performed under local or general anesthesia, often involving painful injections.
- Minimizing patient discomfort during office-based urological procedures is a key clinical goal.
Purpose of the Study:
- To evaluate the effectiveness and safety of topical eutectic mixture of prilocaine and lidocaine (EMLA/Prilox) cream for pain management during urethral meatotomy.
- To determine if topical anesthesia can eliminate the need for conventional penile blocks or general anesthesia.
Main Methods:
- A prospective study involving 32 patients with meatal stenosis undergoing urethral meatotomy.
- Application of 3-4 g of Prilox cream to the glans penis with occlusive dressing for 45 minutes prior to the procedure.
- Pain perception assessed using the Visual Analog Scale (VAS).
Main Results:
- Only one patient (out of 32) reported pain, attributed to improper cream application.
- The mean VAS score was 1.8, indicating minimal to no significant pain perception.
- No major complications were observed during or after the procedure.
Conclusions:
- Topical Prilox (EMLA) cream is a safe and effective anesthetic for urethral meatotomy.
- This method successfully avoids the pain and anxiety associated with injections for penile blocks or general anesthesia.
- Topical anesthesia should be considered a viable alternative for most patients undergoing meatotomy.