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dc.contributor.authorLong, Ronan M.
dc.contributor.authorMcCartan, Damian
dc.contributor.authorCullen, Ivor
dc.contributor.authorHarmon, Dominic
dc.contributor.authorFlood, Hugh D.
dc.date.accessioned2018-09-20T16:14:53Z
dc.date.available2018-09-20T16:14:53Z
dc.date.issued2009-11-04
dc.identifier.citationLong, Ronan M. McCartan, Damian; Cullen, Ivor; Harmon, Dominic; Flood, Hugh D. (2009). A preliminary study of the sensory distribution of the penile dorsal and ventral nerves: implications for effective penile block for circumcision. BJU International 105 (11), 1576-1578
dc.identifier.issn1464-4096
dc.identifier.urihttp://hdl.handle.net/10379/12494
dc.description.abstractOBJECTIVE To determine the sensory innervation of the penis, as regional anaesthesia is often used either for postoperative analgesia or as the sole anaesthetic technique for circumcision. Since first described in 1978 the dorsal penile nerve block has become the standard technique, but some blocks are ineffective; a better understanding of the sensory innervation of the penis might improve the efficacy of the dorsal penile block technique. PATIENTS AND METHODS In 13 men undergoing circumcision with local anaesthetic, cutaneous sensation was tested before and after infiltration of the dorsal aspect of the penis, and then again after infiltration of the ventral aspect. The area of anaesthesia was mapped using pin-prick sensation. RESULTS Ten of the 13 patients showed a similar pattern of sensory distribution. After the dorsal block, the dorsal aspect of the shaft of the penis and glans penis became insensate. The ventral aspect of the shaft remained sensate up to and including the frenulum. After successful ventral infiltration all sensate areas became insensate and circumcision proceeded. In one case the frenulum and distal ventral foreskin was anaesthetized after the dorsal block and ventral infiltration was not required. No patient experienced pain during circumcision. CONCLUSION For consistently successful regional anaesthesia of the foreskin in circumcision, a dorsal block must be used. This should be combined with ventral infiltration at the site of incision. This method will avoid inconsistencies and allow pain-free circumcision using local anaesthesia in most men.
dc.publisherWiley-Blackwell
dc.relation.ispartofBJU International
dc.subjectregional anaesthesia
dc.subjectpenile block
dc.subjectcircumcision
dc.subjectneonatal circumcision
dc.subjectpain relief
dc.subjectanesthesia
dc.subjectneuroanatomy
dc.titleA preliminary study of the sensory distribution of the penile dorsal and ventral nerves: implications for effective penile block for circumcision
dc.typeArticle
dc.identifier.doi10.1111/j.1464-410x.2009.09044.x
dc.local.publishedsourcehttp://onlinelibrary.wiley.com/doi/10.1111/j.1464-410X.2009.09044.x/pdf
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