Adult experience of local anaesthetic circumcision defies consultant beliefs in Scotland

Abstract

Objective: In the United Kingdom, adult circumcision is often performed using general anaesthesia. Our aim was to assess our patients’ experiences of local anaesthetic (LA) circumcision and also the attitudes and practices of urologists in Scotland towards this procedure. Patients and methods: All adult patients undergoing LA circumcision over a 21-month period were asked to complete an anonymous post-operative questionnaire assessing domains such as pre-operative anxiety, anaesthetic discomfort and intra-operative pain. Postal questionnaires were sent to consultant urologists in central Scotland to determine current practice and attitudes for circumcision. Results: Seventy-four patients were included, all of whom were happy with their choice of anaesthesia and would recommend the procedure to a friend. Discomfort during anaesthetic infiltration was low, although approximately a quarter of patients reported feeling relatively mild pain intra-operatively. Just over half of the urologists replied to the questionnaire (53%), with the majority not offering LA circumcision routinely, believing it causes severe discomfort and that patients want a general anaesthesia. Conclusion: LA circumcision is acceptable to patients, avoids the need for pre-assessment, and offers potential cost savings. Our results challenge the beliefs of a number of urologists that LA circumcision is unacceptable to patients.