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The penis is innervated (supplied by nerves) which enter both from the top and underside. A ring of anesthesia could be placed around the base of the penis and ultimately the penis would become anesthetized for 3 to 4 hours if long acting agents are used (which is what we do). Please understand distal nerves are always in the center of the nerve bundle, so when injecting they are the last to become anesthetized. This could take up to 20 minutes as patients don’t want to feel anything.

Our injection technique uses the “advancing wheal” principle. A wheal is a swelling like you could get from an insect bite.

In that we are always pushing anesthetic in with our syringe in advance of the needle, ideally you should only feel one needle stick.

However, waiting for a ring of anesthesia at the base to take effect distally could take 20 minutes, if we inject anesthesia both at the base and more distally in the circumcision area, we achieve total anesthesia in about 10 minutes. Anesthesia costs virtually nothing, so this is what we do staying within the limits of safety.

For those who do not wish to feel even a needle stick, EMLA or Betacaine cream can be applied to the skin and after 20 minutes, the skin is numb.

Most of our patients are quite manly and tolerate a little needle stick or pinch without making a big to do over this.

When I see the dentist I say “no anesthesia” whatsoever unless he really insists.

I only wish you could talk to over 5000 patients we have done here and you would hear a resounding reassurance, “this is not at all painful.”

My assistant Anne and I once traveled 2500 miles to Nevada to hear a doctor lecture on ambulatory surgery and he said rule number one is never to hurt your patients. And we looked at each other and said, “do you mean we came 2500 miles to hear someone tell us this no brainer.” But you know, this was the best advice we could have ever received.

Harold M. Reed, M.D.

— In PROCIRCORG@yahoogroups.com, “Ms. VG”  wrote:
I’m curious to know with local injections, to which part of the penis or pubic area is injected? Also how many injections are there?

 if there is more than one, does the doctor wait at least until the first injection takes effect? How many injections total?

Thanks.

 VJ

This entry was posted on Wednesday, May 27th, 2009 at 2:07 pm and is filed under adult circumcision, Adult Male Circumcision, circumcision. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.