Initially, an Ativan may be offered to anxious patients about 30 minutes before the start of surgery. Anesthesia is performed by a penile block. This involves the administration of an anesthetic to the skin around the base of the penis.
This is usually the most unpleasant part of the surgery. It lasts only a short time, about 15 seconds. The patient is then returned to the waiting room for 10 minutes to wait for the penile block to set in.
In a second step, the patient is placed on his back. We administer a Chlorexidine aseptic and sterile drapes are put in place. Anesthesia is verified. If necessary, we use Xylocaine. We may sometimes mark the skin. Then, a circular excision of the skin is performed with a scalpel and the bleeding is stopped using electrocautery.
Thereafter, we proceed to the excision of the preputial mucosa, and there is a second hemostasis with electrocautery. If necessary, we use 0.2% Xylocaine 10 cc.
Subsequently, the physician performs the excision of the prepuce mucosa, and there is a second hemostatic electrocauterisation. We attach the penile skin to the prepuce using absorbable sutures. If necessary, we use Xylocaine 0.2% 10 cc.
What wound closure technology will be favoured: threads or glue?
Finally, an aesthetic closure is performed. It can be achieved with continuous resorbable threads. This technique leaves less scar marks than with the use ofseparated sutures of the standard technique.
The closure may also be performed by surgical glue without any apparent sutures. This closure technique is only possible if the edges of the closure can be perfectly aligned. Obviously, there will be no secondary scar marking as for skin closure!