In-Office Circumcision without an assistant

M. Mass Lindenbaum, A. Bautista Pérez Gavilán, P. Bajic

Adult Circumcision, Phimosis, Office-Based Surgery, Local Anesthesia, Cost-Effectiveness, Men's Health

Phimosis affects approximately 3.4% of adult males in the United States, a prevalence that may rise alongside the increasing use of SGLT2 inhibitors for diabetes management, which are associated with recurrent balanoposthitis. While adult circumcision is traditionally performed in the operating room, this setting often incurs higher costs and utilizes valuable block time for lower-acuity cases. This video demonstrates a safe, feasible, and cost-effective technique for performing adult circumcision in the office setting under local anesthesia.

We present our institutional experience and surgical technique, highlighting patient selection criteria such as tolerance for needles and the absence of buried penis. The procedure is generally well-tolerated, takes approximately 30 minutes, and allows for the continuation of anticoagulation therapies. In our series of approximately 15 cases since 2020, we have observed excellent post-operative cosmetic results and high patient satisfaction with no reported complications. This video serves as a guide for urologists to transition appropriate cases from the operating room to the clinic, optimizing reimbursement and avoiding general anesthesia.

None.

The authors have nothing to disclose

1. Unnikrishnan AG, et al. Genital Infections with Sodium Glucose Cotransporter-2 Inhibitors: Occurrence and Management in Patients with Type 2 Diabetes Mellitus. Indian J Endocrinol Metab, 2018; 22(6): 837-842.

2. Morris BJ, et al. Prevalence of Phimosis in Males of All Ages: Systematic Review. Urology, 2020.