title: Phimosis. Preputial plasty using transversal widening on the dorsal side with EMLA local anesthetic cream.
abstract: OBJECTIVE
  In the United States, the treatment of choice for the correction of phimosis is circumcision, whereas in European countries, the condition is usually treated by preputial plasty using Duhamel's method or modified versions. We report our experience in correcting phimosis by preputial plasty using transversal widening on the dorsal side with EMLA local anesthetic cream.
  
  
  METHODS
  Twenty-six patients with phimosis were operated on by preputial plasty, under local anesthesia with EMLA cream. A transversal incision is made on the dorsal side of the ring of prepuce, like 3 contiguous Ts, the middle one inverted with the long arm on the preputial mucosa side. The 2 small mucocutaneous flaps of the prepuce are separated and then sutured with interrupted stitches, thus transforming the incisions from T to V.
  
  
  RESULTS
  No postoperative complications were observed. At 1-year follow-up, the cosmetic and functional results were satisfactory.
  
  
  CONCLUSIONS
  The technique of preputial plasty that the authors present enlarges the stenotic ring of prepuce by a transversal widening on the dorsal side. The ring of prepuce obtained is wide and symmetrical on its dorsal and ventral sides and therefore cosmetically and functionally satisfactory. It is a good alternative to the more radical circumcision technique.
authors.affiliation: Unit of Pediatric Surgery, University of Sassari, 07100 Sassari, Italy. antoniodessanti@yahoo.it <antoniodessanti@yahoo.it>
authors.forename: Antonio
authors.initials: A
authors.lastname: Dessanti
authors.forename: Giorgio
authors.initials: G
authors.lastname: Ginesu
authors.forename: Marco
authors.initials: M
authors.lastname: Iannuccelli
authors.forename: Antonio
authors.initials: A
authors.lastname: Balata
mesh_terms: D000779:Anesthetics, Local / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D006801:Humans; D008012:Lidocaine / Q000627:therapeutic use*; D000077442:Lidocaine, Prilocaine Drug Combination; D008297:Male; D010413:Penis / Q000601:surgery*; D010688:Phimosis / Q000601:surgery*; D011318:Prilocaine / Q000627:therapeutic use*; D012189:Retrospective Studies; D013524:Surgical Flaps; D013521:Urologic Surgical Procedures, Male / Q000379:methods
chemical_list: D000779:Anesthetics, Local; D000077442:Lidocaine, Prilocaine Drug Combination; D011318:Prilocaine; D008012:Lidocaine