Anatomic evidence of dorsal penile nerve block for circumcision and its clinical applications

Objective: To study the anatomic evidence and its clinical applications of dorsal penile nerve block（DPNB） for circumcision.Methods: Nine male cadavers including one adult,three children,three infants,one newborn and one fetus freshened with formalin were dissected to show the exact anatomy of dorsal nerves and vasculatures of penile.Anatomic microscope,magnifying glass and eye-observation were used to observe the distribution and running of the above structures.The anatomic evidence of dorsal penile nerve deciding the exact points of analgesia,ten children suffered from phimosis received circumcision with two points DPNB anesthesia.VAS（visual analysis of simulation） was used to evaluate the anesthesia effectiveness.Results: Dorsal penile nerves presented beneath the pubic symphysis at the root of penile in the position of two and ten o’clock,extending and ending to the glan of penis longitudinally.Dorsal penile deep arteries presented to the medial of nerves on both sides,and dorsal penile deep vein was in the middle of penis.Injecting to the two exact points of nerves at the root of penis just beneath the pubic symphysis,we got VAS of 0mm to 4mm（no pain to mild pain） after analgesia immediately.With 7 to 15 minutes operation period,VAS presented with 0mm to 1mm.Conclusion: DPNB of injection to the exact two points（2 and 10 o′clock beneath the pubic symphysis at the root of penis） in circumcision has its anatomic evidence with good clinical effects.