Effective penile block for circumcision in adults

Abstract

The dorsal nerve block of the penis during circumcision has not been standardized and the effectiveness of the block can be changeable. The aim of this study was to determine which technique is more suitable for blocking sensory innervations of penis. This prospective study was done on adults who voluntarily applied to be circumcised. Patients were randomized into three distinctive groups; first, just circular infiltration; second, circular plus dorsal penile infiltration; and third, circular plus ventral upward infiltration. Sensation was tested using pinprick sensory testing before and after infiltration. The total duration of the procedure was recorded. In total, 89 adult uncircumcised men were included into the study. The average age of men was 21.4 (min: 20; max: 25). The average operation time in the third group was significantly shorter. The sensation distribution, especially around the frenulum sensitivity results were in the first minute 100, 81.3, 72.4%; in the third minute 85.7, 37.5, 20.7%; and in the fifth minute 57.1, 18.8, and 0% for the first, second, and third group, respectively. In the fifth minute, there was no sensitivity for any patients in the third group and it was significant. Circular plus ventral upward anesthesia is an easy and feasible technique for local anesthesia in circumcision.