This video was produced at Cornell Brady Urology Studio, Center for Male Reproductive Medicine and Microsurgery, Department of Urology, Weill Cornell Medical College./nWe used a local anesthetic jet injection...
This video was produced at Cornell Brady Urology Studio, Center for Male Reproductive Medicine and Microsurgery, Department of Urology, Weill Cornell Medical College./nWe used a local anesthetic jet injection technique for adult male circumcision.This method eliminates needle use and may decrease the fear of local
anesthetic injection used for male circumcision.
Materials and Methods: We recruited 60 men seeking voluntary adult male
circumcision into the study from June to September 2009. We used a MadaJet®
Medical Injector to deliver a high pressure spray of 0.1 ml 2% plain lidocaine
solution directly through the penile skin circumferentially around the proximal
third of the penis. All men underwent circumcision using the Shang Ring™ and
were evaluated for anesthetic safety, efficacy and acceptability. Pain was measured
on a visual analog scale.
Results: The average volume of 2% lidocaine anesthetic solution delivered by jet
injection was 0.1 ml with a mean total of 0.9 ml per circumcision procedure. More
than 85% of men did not require supplemental anesthesia. Anesthetic onset
required approximately 45 seconds from the time that injections were completed.
Mean pain scores for immediate postoperative, 24-hour postoperative, ring removal
and post-ring removal events were 0.1, 6.8, 2.2 and 0.9, respectively. In 4
patients (6.67%) mild urethral bleeding resolved with pressure, resulting in
Conclusions: No-needle jet injection is safe and effective for adult MC. The
technique efficiently delivers local anesthesia with rapid onset in men undergoing
circumcision. This needle-free approach may enhance the popularity of adult
male circumcision./nCenter for Male Reproductive Medicine and Microsurgery
Cornell Institute for Reproductive Medicine
Department of Urology
Weill Cornell Medical College
New York-Presbyterian Hospital
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