You have accessJournal of UrologyMale Voiding/Sexual Dysfunction/BPH/ Incontinence/Infection/Infertility1 Apr 2015V3-08 A SIMPLIFIED NO-FLIP SHANG RING CIRCUMCISION TECHNIQUE WITH TOPICAL (EMLA) ANESTHESIA IN ADOLESCENTS AND ADULTS Aaron Bernie, Yifeng Peng, Philip Li, Richard Lee, Chao Jia, Benhai Yang, Quentin Awori, Nian Qing Lu, Mark Barone, and Marc Goldstein Aaron BernieAaron Bernie More articles by this author , Yifeng PengYifeng Peng More articles by this author , Philip LiPhilip Li More articles by this author , Richard LeeRichard Lee More articles by this author , Chao JiaChao Jia More articles by this author , Benhai YangBenhai Yang More articles by this author , Quentin AworiQuentin Awori More articles by this author , Nian Qing LuNian Qing Lu More articles by this author , Mark BaroneMark Barone More articles by this author , and Marc GoldsteinMarc Goldstein More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1349AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Numerous clinical and randomized controlled trials have confirmed that the Shang Ring is a safe, simple, and rapid method for performing adult and adolescent male circumcision. It has the potential to play an important role for reducing human immunodeficiency virus (HIV), human papillomavirus (HPV), and herpes simplex virus 2 (HSV-2) transmission in Africa. The advent of the no-flip Shang Ring circumcision procedure provides several advantages over the standard Shang Ring technique, such as eliminating the need to evert the foreskin over the inner ring and thus simplifying the overall technique. We now introduce the use of topical anesthesia will also eliminate the pain and morbidity associated with injectable anesthesia. METHODS No-flip Shang Ring circumcision was performed on 183 males (142 adults, 41 adolescents) with topical EMLA anesthesia. Topical anesthesia was applied inside and around the foreskin and with a dwell time of 25 to 30 minutes prior to circumcision. After circumcision, patients were asked to assess their pain both during the procedure as well as 24 hours after the procedure using the visual analog scale (VAS). RESULTS Mean no-flip Shang Ring circumcision procedural time was less than 4 minutes. Adolescents reported low pain scores during the Shang Ring circumcision with a mean VAS score of 2.3, despite 51% (n=21) of patients having a tight phimosis. 24 hour post-procedural pain remained low in these patients with a mean score of 2.7. Adult patients also reported low pain scores, with a mean VAS of 1.6 during circumcision and 2.2 24 hours post-procedure. CONCLUSIONS The no-flip Shang Ring circumcision can be successfully performed in a rapid fashion with topical EMLA anesthesia in adults and adolescents. Men undergoing this procedure experienced little pain during the procedure and minimal post-procedural pain. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e337 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Aaron Bernie More articles by this author Yifeng Peng More articles by this author Philip Li More articles by this author Richard Lee More articles by this author Chao Jia More articles by this author Benhai Yang More articles by this author Quentin Awori More articles by this author Nian Qing Lu More articles by this author Mark Barone More articles by this author Marc Goldstein More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...