Penile dorsal slit - Revision history

Rossdonaldson1: /* Procedure */

2021-05-08T06:22:18Z

Procedure

← Older revision		Revision as of 06:22, 8 May 2021
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	==Procedure==		==Procedure==
			[[File:Dorsal slit.jpg\|thumb\|Single incision along the upper length of the foreskin from the tip to the corona, exposing the glans without removing any tissue.]]
	#Prep and drape penis in sterile fashion		#Prep and drape penis in sterile fashion
	#Using a 27 gauge needle, raise a wheal of anesthetic in the foreskin		#Using a 27 gauge needle, raise a wheal of anesthetic in the foreskin

SLuckettG: /* Complications */

2019-05-15T20:42:58Z

Complications

← Older revision		Revision as of 20:42, 15 May 2019
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	==Complications==		==Complications==
	~~#bleeding~~		*Bleeding
	~~#pain~~		*Pain
	~~#infection~~		*Infection
	~~#damage~~ to glans or urethra		*Damage to glans or urethra

	==See Also==		==See Also==
	*[[Paraphimosis Reduction]]		*[[Paraphimosis Reduction]]

SLuckettG: /* Procedure */

2019-05-15T20:42:18Z

Procedure

← Older revision		Revision as of 20:42, 15 May 2019
Line 26:		Line 26:

	==Procedure==		==Procedure==
	*Prep and drape penis in sterile fashion		#Prep and drape penis in sterile fashion
	*Using a 27 gauge needle, raise a wheal of anesthetic in the foreskin		#Using a 27 gauge needle, raise a wheal of anesthetic in the foreskin
	**Just proximal to the glans on the dorsal aspect of the penis		#*Just proximal to the glans on the dorsal aspect of the penis
	#Extend the injection along the longitudinal axis until entire foreskin is anesthetized		#Extend the injection along the longitudinal axis until entire foreskin is anesthetized
	#After 4 min, check effectiveness of anesthetic		#After 4 min, check effectiveness of anesthetic

SLuckettG: /* Procedure */

2019-05-15T20:41:54Z

Procedure

← Older revision		Revision as of 20:41, 15 May 2019
Line 26:		Line 26:

	==Procedure==		==Procedure==
	~~#prep~~ and drape penis in sterile fashion		*Prep and drape penis in sterile fashion
	#raise a wheal of ~~anesthesia~~ in the foreskin~~, just~~ proximal to the glans on the dorsal aspect of the penis ~~(27-gauge needle)~~		*Using a 27 gauge needle, raise a wheal of anesthetic in the foreskin
	#Extend the injection along the longitudinal axis ~~distally to the tip of the~~ foreskin		**Just proximal to the glans on the dorsal aspect of the penis
	#After 4 min, check ~~to make certain the anesthesia is effective~~		#Extend the injection along the longitudinal axis until entire foreskin is anesthetized
	#Slide ~~the hemostats along the space~~ between ~~the~~ foreskin ~~and the glans, and gently~~ open~~, forming~~ a tract.		#After 4 min, check effectiveness of anesthetic
	#Remove ~~the hemostats, then replace~~ with ~~one tip between~~ the foreskin ~~and glans, and one tip outside the foreskin, straddling the region of anesthesia. Make certain the tip of the hemostats~~ is not in ~~the~~ urethral meatus.		#Slide closed hemostat between dorsal penis and foreskin
	#Close ~~the~~ hemostat ~~over the region of anesthesia and keep clamped~~ for 10 ~~min.~~		#Gently open hemostat to create a tract
	#Remove ~~the~~ hemostat~~, and~~ cut ~~the serrated clamped~~ tissue ~~with the scissors.~~		#Remove hemostat
	#~~#(If the skin edges continue~~ to ~~ooze,~~ a running stitch ~~using a vicryl suture can be placed on each side)~~		#Open hemostat and insert bottom prong along previously created tract with top prong above the foreskin
	#~~Retract the foreskin and clean the~~ glans		#*Carefully ensure that hemostat is not in urethral meatus
	##(Place a Foley catheter ~~when indicated)~~		#Close hemostat to crush foreskin tissue
			#Leave hemostat in place for 10 minutes
			#Remove hemostat
			#Use iris scissors to cut crushed tissue
			#Use vicryl to place a running stitch along cut ends of foreskin if oozing is excessive or persistent
			#Clean glans
			#Place Foley catheter if needed

	==Complications==		==Complications==

SLuckettG: /* Equipment Needed */

2019-05-15T20:37:34Z

Equipment Needed

← Older revision		Revision as of 20:37, 15 May 2019
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	==Equipment Needed==		==Equipment Needed==
	~~#betadine~~		*Betadine or other antiseptic prep solution
	~~#sterile~~ gloves/drape		*Sterile gloves and drape
	~~#local anesthesia~~		*Local anesthetic
	#27 gauge needle		*27 gauge needle
	#3cc syringe		*3cc syringe
	~~#straight~~ hemostats or ~~kelly~~ clamp		*Straight hemostats or Kelly clamp
	~~#iris~~ scissors		*Iris scissors
	~~#vicryl~~ suture (3-0 or 4-0)		*Vicryl suture (3-0 or 4-0)
	~~#needle~~ driver		*Needle driver
	~~#gauze~~		*Gauze

	==Procedure==		==Procedure==
	#prep and drape penis in sterile fashion		#prep and drape penis in sterile fashion

SLuckettG: /* Contraindications */

2019-05-15T20:25:22Z

Contraindications

← Older revision		Revision as of 20:25, 15 May 2019
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	==Contraindications==		==Contraindications==
	~~#no~~ absolute contraindications		*No absolute contraindications
	~~##consult~~ urologist ~~prior to procedure~~ if ~~there~~ is ~~evidence~~ of overlying infection~~, patients who are immunocompromised, or in those with~~ coagulation disorder		*Should be performed by urologist if consultation is immediately available
			*Caution when:
			**Evidence of overlying infection
			**Patient immune compromised
			**Patient has coagulation disorder

	==Equipment Needed==		==Equipment Needed==

SLuckettG: /* Indications */

2019-05-15T20:24:19Z

Indications

← Older revision		Revision as of 20:24, 15 May 2019
Line 1:		Line 1:
	==Indications==		==Indications==
	#Relieve [[~~Paraphimosis~~]] ~~that is strangulating the glans~~		*Relieve [[paraphimosis]]
	#[[Phimosis]] causing urinary retention		**After failure of non-invasive reduction
			**Emergent urology consult not available
			*[[Phimosis]] causing urinary retention

	==Contraindications==		==Contraindications==

Neil.m.young: Text replacement - "# " to "#"

2016-07-07T01:44:48Z

Text replacement - "# " to "#"

← Older revision		Revision as of 01:44, 7 July 2016
Line 1:		Line 1:
	==Indications==		==Indications==
	# Relieve [[Paraphimosis]] that is strangulating the glans		#Relieve [[Paraphimosis]] that is strangulating the glans
	# [[Phimosis]] causing urinary retention		#[[Phimosis]] causing urinary retention

	==Contraindications==		==Contraindications==
	# no absolute contraindications		#no absolute contraindications
	## consult urologist prior to procedure if there is evidence of overlying infection, patients who are immunocompromised, or in those with coagulation disorder		##consult urologist prior to procedure if there is evidence of overlying infection, patients who are immunocompromised, or in those with coagulation disorder

	==Equipment Needed==		==Equipment Needed==
	# betadine		#betadine
	# sterile gloves/drape		#sterile gloves/drape
	# local anesthesia		#local anesthesia
	# 27 gauge needle		#27 gauge needle
	# 3cc syringe		#3cc syringe
	# straight hemostats or kelly clamp		#straight hemostats or kelly clamp
	# iris scissors		#iris scissors
	# vicryl suture (3-0 or 4-0)		#vicryl suture (3-0 or 4-0)
	# needle driver		#needle driver
	# gauze		#gauze

	==Procedure==		==Procedure==
	# prep and drape penis in sterile fashion		#prep and drape penis in sterile fashion
	# raise a wheal of anesthesia in the foreskin, just proximal to the glans on the dorsal aspect of the penis (27-gauge needle)		#raise a wheal of anesthesia in the foreskin, just proximal to the glans on the dorsal aspect of the penis (27-gauge needle)
	# Extend the injection along the longitudinal axis distally to the tip of the foreskin		#Extend the injection along the longitudinal axis distally to the tip of the foreskin
	# After 4 min, check to make certain the anesthesia is effective		#After 4 min, check to make certain the anesthesia is effective
	# Slide the hemostats along the space between the foreskin and the glans, and gently open, forming a tract.		#Slide the hemostats along the space between the foreskin and the glans, and gently open, forming a tract.
	# Remove the hemostats, then replace with one tip between the foreskin and glans, and one tip outside the foreskin, straddling the region of anesthesia. Make certain the tip of the hemostats is not in the urethral meatus.		#Remove the hemostats, then replace with one tip between the foreskin and glans, and one tip outside the foreskin, straddling the region of anesthesia. Make certain the tip of the hemostats is not in the urethral meatus.
	# Close the hemostat over the region of anesthesia and keep clamped for 10 min.		#Close the hemostat over the region of anesthesia and keep clamped for 10 min.
	# Remove the hemostat, and cut the serrated clamped tissue with the scissors.		#Remove the hemostat, and cut the serrated clamped tissue with the scissors.
	##(If the skin edges continue to ooze, a running stitch using a vicryl suture can be placed on each side)		##(If the skin edges continue to ooze, a running stitch using a vicryl suture can be placed on each side)
	# Retract the foreskin and clean the glans		#Retract the foreskin and clean the glans
	##(Place a Foley catheter when indicated)		##(Place a Foley catheter when indicated)

	==Complications==		==Complications==
	# bleeding		#bleeding
	# pain		#pain
	# infection		#infection
	# damage to glans or urethra		#damage to glans or urethra

	==See Also==		==See Also==

Neil.m.young: Text replacement - "==Source==" to "==References== "

2016-06-26T15:22:31Z

Text replacement - "==Source==" to "==References== <references/>"

← Older revision		Revision as of 15:22, 26 June 2016
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	*[[Paraphimosis]]		*[[Paraphimosis]]

	==~~Source~~==		==References==
			<references/>
	Emedicine		Emedicine

	[[Category:Procedures]]		[[Category:Procedures]]
	[[Category:Urology]]		[[Category:Urology]]

Ostermayer: Text replacement - "Category:GU" to "Category:Urology"

2016-03-22T17:01:25Z

Text replacement - "Category:GU" to "Category:Urology"

← Older revision		Revision as of 17:01, 22 March 2016
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	[[Category:Procedures]]		[[Category:Procedures]]
	[[Category:GU]]		[[Category:Urology]]