Dr. Reed, Which adult circumcision anesthesia is best? For sure I don’t want to feel it or have much post-operative pain.
We share your concerns and do 99.9 % of our adult circumcision patients under local. Our approach is to numb your penis with an anesthetic skin cream for about 15 minutes so you do not feel a needle stick. Then we use a 1/3rd mixture of Xylocaine (lidocaine) 1% with 1/100,000 of epinephrine and 2/3’rd bupivicaine or Marcaine 0.25% mixed with a small amount of sodium bicarbonate which also helps to minimize any sting effect. This is applied mostly to the base of the penis using the “advancing wheal” technique. That means a subsequent needle stick is placed into an area already anesthetized. Both anesthetics are long acting and last about 3 to 4 hours. The epinephrine reduces bruising. We allow about 15 minutes for this anesthetic to set up and we squeeze the penile tissues to be sure the anesthettc it is well distributed.
After surgery, I apply a compressive 2 layered wrap to reduce bruising. This also helps to minimize post-operative pain. The rest is doing the circumcision style you select and we dioscuss that in a relaxed manner both in the office and the exam room before you’re brought back to the operating suite. Please look at our web-site pensidoctor.com for photographic examples of our work.
Hoping this is of help,
Harold M. Reed, M.D. FICS
Senior Member of the American Urological Association
Member Society of Genito-Urinary Reconstructive Surgeons
Founding Member and Treasurer of American Academy of Phalloplasty Surgeons
Founding Member Sexual Society of North America
International Society for Sexual Medicine
Our practice and specialization is listed by the Urology Care Foundation (American Urological Association) http://www.urologyhealth.org/find-a-urologist