Adult urologyUse of EMLA cream with vasectomy
Section snippets
Material and methods
Ninety-three men were counseled between February and October 1998 regarding vasectomy and informed consent was obtained. The study protocol was shared with each couple, and 89 men agreed to participate. Each study patient was asked to report to the clinic 1 hour before the planned surgery. The adequacy of his scrotal shave was confirmed, and each cream was applied to the ventral surface of the scrotum, with care taken not to mix the creams across the median raphe. The patient was familiarized
Results
Figure 1 demonstrates the visual analogue scores the 89 patients recorded for the hemiscrotum pretreated with EMLA. Twenty-five patients had no pain with the needle injections of lidocaine and 4 patients recorded a visual analogue score of 5.
Figure 2 demonstrates the visual analogue score the 89 patients recorded for the hemiscrotum pretreated with placebo cream. Four patients recorded a 0 score and 7 patients recorded a 5.
Figure 3 demonstrates the patient preferences for EMLA and placebo
Comment
Vasectomy is the single least invasive and most cost-effective surgical method of birth control known.6 Tubal ligation is far more invasive because general or spinal anesthesia is needed. Tubal complication rates are significantly higher than vasectomy complication rates.7 Despite these factors, only 12% of American men between the ages of 25 and 39 years get a vasectomy.8 The absolute number of American men seeking vasectomy has not increased between 1991 and 1995,9 despite inducements
Acknowledgements
To Gary M. Stack who performed 35 of the vasectomies.
References (10)
- et al.
Clinical aspects of vasectomies performed in the United States in 1995
Urology
(1998) Pain during vasectomya prospective audit
Br J Theatre Nurs
(1999)- et al.
Topical anesthesia with eutectic mixture of local anesthetic cream in vasectomy2 randomized trials
J Urol
(1992) - et al.
Use of EMLA during local anesthetic vasectomy
Br J Urol
(1995) Premature ejaculation
Presented at University Urology Forum
(1998)
Cited by (18)
Outpatient Vasectomy: Safe, Reliable, and Cost-effective
2021, Primary Care - Clinics in Office PracticeCitation Excerpt :The room should be warm (21°C–27°C [70°–80° F]), even though a cooler temperature may be more comfortable for the physician.7 Application of a topical eutectic mixture of local anesthetic (EMLA) cream reduces the pain of the anesthetic injection when applied 1 hour before incision.8 Povidone iodine or chlorhexidine to cleanse the scrotal skin.
Vasectomy
2013, Urologic Clinics of North AmericaCitation Excerpt :Lidocaine or bupivacaine without epinephrine are typically the local anesthetic agent of choice, and are injected using a small needle (eg, 25 gauge or smaller) to reduce patient discomfort. Some clinicians apply an anesthetic cream to the skin before the needle stick, although it is unclear whether this significantly decreases pain.7,8 Vasectomy is performed in 2 distinct steps: delivering and exposing the vas deferens out of the scrotum (vas isolation), and occluding the vas.
Vasectomy: The other (better) form of sterilization
2011, ContraceptionCitation Excerpt :needle [6]. Suggested improvements to this technique to minimize pain during vasectomy have included using EMLA (eutectic mixture of local anesthetics) cream alone or as an adjunct to infiltration anesthesia, buffering anesthesia, spermatic cord block, the no-needle jet injector technique, and a mini-needle technique [7–15]. Overall, pain during vasectomy is well-controlled.
Minimizing Pain During Vasectomy: The Mini-Needle Anesthetic Technique
2010, Journal of UrologyCitation Excerpt :Since this is a descriptive study without an inherent comparison group, we performed a literature search using the key words vasectomy and anesthesia in MEDLINE® in July 2009 to provide some comparison for our results. From 197 titles and abstracts we identified 10 articles providing pain scores associated with local anesthesia during vasectomy.8,10–12,14–17,25–27 An additional article was found in the personal database of one of us.27
Techniques of Vasectomy
2009, Urologic Clinics of North America