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. 2012 Sep;4(3):145-9.
doi: 10.4103/0974-7796.102658.

The efficacy and safety of topical EMLA cream application for minor surgery of the adult penis

Kostis I Gyftopoulos  1
Affiliations

The efficacy and safety of topical EMLA cream application for minor surgery of the adult penis

Kostis I Gyftopoulos. Urol Ann. 2012 Sep.

Abstract

Background and objectives: A variety of surgical procedures of the penis can be performed under local anesthesia. We evaluated the efficacy and safety of EMLA cream anesthetic in such procedures.

Materials and methods: In total 330 adult patients were subjected to minor penile surgery including: Complete circumcision (73), short frenulum plasty (168), meatotomy (14), fulguration of penile warts (56) and fulguration of urethral (meatal) warts (19). The level of anesthesia obtained by EMLA cream application along with any adverse effects was recorded.

Results: The use of EMLA on mucosal lesions provided excellent level of local anesthesia in almost all patients (245/246, 99.5%). Anesthesia of skin lesions was in part influenced by the site of application. Circumcision patients showed the lowest efficacy of the EMLA cream as the majority (~80%) required some form of further anesthesia until the completion of the procedure. No significant adverse effects were noted. A transient erythema was present in almost all mucosal applications.

Conclusions: The topical anesthetic EMLA cream is a useful, efficient and safe tool for minor surgical procedures of the penis at the office setting, with the exception of circumcision, where an additional type of anesthesia is likely to be necessary. Side effects can be kept to a minimum when the suggested doses are respected (especially at mucosal application) and the time allowed for action is carefully tailored to the site of application and the type of procedure.

Keywords: EMLA; penis; surgery; topical anesthesia.

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Conflict of interest statement

Conflict of Interest: None

Figures

Figure 1
Figure 1
(a) A short frenulum case in a young patient. (b) Note limited amount of EMLA cream applied just before placement of the dressing
Figure 2
Figure 2
(arrow, a) A urethral wart protruding from the external urethral meatus. (b) Infusion of anesthetic through the meatus
Figure 3
Figure 3
(arrows, a) Multiple penile warts at the dorsal surface of the preputial ridge. (b) Application of the occlusive dressing
Figure 4
Figure 4
(a) Multiple HPV lesions (penile warts) at the frenular area and (b) the glans penis
See this image and copyright information in PMC

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