Testicular block using intra-testicular lidocaine: a new anaesthetic technique for percutaneous testis biopsy.
OBJECTIVE
We describe a simple technique to deliver local anaesthetic for percutaneous testis biopsies.


METHODS
With the testis held firmly, a 25 gage needle is used to inject lidocaine, without epinephrine, into the skin and dartos superficial to the testis, then the needle is advanced through the tunica albuginea and 0.5 mL to 1.0 mL of lidocaine is injected directly into the testis. The testis becomes slightly more turgid with the injection. A percutaneous biopsy is then immediately performed.


RESULTS
Intra-testicular lidocaine, (without need of a cord block or any sedation) was used on a total of 45 consecutive patients having percutaneous testicular biopsies. Procedure time was short (averages less than 5 minutes) and anaesthesia was profound. There was no change in the number of seminiferous tubules for evaluation compared to biopsies on men using a cord block. Only 1/45 men had a post-procedure testicular hematoma (this resolved in 4 weeks).


CONCLUSIONS
Intra-testicular lidocaine appears to be a simple, rapid and safe method to provide anaesthesia for a percutaneous testis biopsy.
Division of Urology, Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.
Khaled
K
Kamal
Armand
A
Zini
Keith
K
Jarvi
D000772:Anesthesia, Local; D000779:Anesthetics, Local / Q000008:administration & dosage*; D001706:Biopsy / Q000009:adverse effects*; D006801:Humans; D007267:Injections; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D009407:Nerve Block / Q000379:methods*; D010149:Postoperative Pain / Q000517:prevention & control*; D013737:Testis / Q000473:pathology*
D000779:Anesthetics, Local; D008012:Lidocaine