ABSTRACT
Objective: To critically evaluate the effectiveness of glans and intracorpus spongiosum anesthesia in performing internal urethrotomy for anterior urethral strictures. Patients and Methods: In this prospective study; 43 patients with anterior urethral strictures underwent visual internal urethrotomy under intracorpus spongiosum anesthesia. A small amount of eutectic mixture of local anesthetic (EMLA; Astra Zeneca) was applied to the glans penis as a topical anesthetic. Fifteen minutes later; 3 ml of 2plain lidocaine was injected into the glans and routine internal urethrotomy was performed. The effectiveness of the anesthesia was evaluated by asking the patient to indicate his level of pain using the visual analogue scale. Results: Internal urethrotomy was successfully completed in 39 patients (91); 4 cases were unsuccessful; two on account of bleeding and the other two because the strictures were found to be impassable. No procedure was abandoned on account of severe pain. The pain scores reported by patients ranged between 0 and 4; with an average of 1.6. Conclusion: Criteria indicating sufficient pain therapy (using the numerical visual analogue scale) are pain levels of 3 or less. In the study 98of patients met this criterion providing evidence of the efficacy of this method. In areas where anesthetic services are limited; this technique provides a cheap; safe and effective alternative