Outpatient Surgical Procedures

Outpatient Surgical Procedures

Outpatient surgical procedures usually take less than one hour and allow the patient to return home on the same day. In these procedures, the patient does not need general anesthesia or hospitalization. The outpatient procedures performed in our office under local anesthesia are as follows:

Penile Skin Bridge or Penile Adhesion

Skin bridges or adhesions of the glans penis skin are extra skin bands that usually develop after circumcision. During circumcision, excess skin around the glans is removed, and over the next few days the circumcision wound heals. Sometimes this healing does not occur properly, and part of the skin of the glans and shaft heals abnormally, creating excess skin bands.
These excess bands have a bridge-like shape, and secretions and debris can collect underneath them. In adulthood, a person may feel that part of the penile skin has formed a small pocket, with occasional discharge from underneath.
A penile skin bridge can become infected and painful; it can also be a cosmetic concern for young men.
Correction and repair of these excess bands can be done easily and may be performed for cosmetic reasons. To repair these lesions in the office, the urologist uses local anesthesia and injects anesthetic solution under the skin with an insulin syringe and a fine needle, then cuts the abnormally healed area with a surgical blade or laser and corrects the lesion.
After repair, a local dressing with antibiotic ointment is used for 2-3 days. Surgical treatment of these lesions is not painful and does not interfere with the person's daily life.

Urethral Meatal Stenosis or Narrowing of the Urethral Opening

Narrowing of the urethral opening usually occurs in children, but it can also occur in adults. In children, after circumcision, contact between the glans skin and urine can inflame the urethral opening, and the resulting ulcer-like irritation can lead to narrowing of the urinary meatus.
In children, the procedure to open the urethral meatus is performed in the hospital because they often cannot tolerate local anesthesia in the office.
In adults, narrowing of the urethral opening can also occur after urethral instrumentation, prostate surgery, or lichen sclerosus; opening this narrowing can be performed in the office under local anesthesia.

Hemangioma

Hemangiomas are masses of tiny subcutaneous blood vessels that appear on the skin like moles (they are also called vascular moles) and may be mistaken for warts in adulthood.
The clearest difference between a hemangioma and other moles is its bluish, blood-like appearance, which makes diagnosis easier. An example is the large red moles seen on the skin of the face and neck in some adults.
A hemangioma is not malignant or usually troublesome; rather, it is a congenital condition that appears in infancy. However, in adulthood, scattered small hemangiomas are sometimes seen on the skin of the scrotum. Removing a hemangioma is not necessary unless it is very large, bleeds, or causes cosmetic distress. Different treatment methods for hemangioma include:

• topical timolol solution

• oral propranolol

These two treatments may be used in children for up to 1 year. If the hemangioma is large, the physician may use an intralesional steroid injection.
Laser treatment or electrocautery are methods performed under local anesthesia using an insulin syringe and a fine needle. In laser treatment or electrocautery, which is usually done in the office as an outpatient procedure, the area of skin affected by the hemangioma is numbed and the hemangioma is cauterized. Recovery is short, and the person can return to normal life within one day.

Sebaceous Cysts

A sebaceous cyst, or epidermoid cyst, is a benign white, ball-shaped lesion that may appear in large numbers on the skin of the scrotum and testicles.
People with this condition develop multiple lesions of different sizes. Blockage of hair follicle ducts by oil and skin keratin leads to formation of these cysts under the skin. Genetics may also play a role in this disorder.
These cysts are usually not bothersome, but a person may see a doctor for cosmetic reasons or sometimes because the cysts become inflamed or infected, with pain, redness, and swelling. Treatment is possible only by surgical removal; medication is not helpful.
Removal of these cysts can be done simply in the office as an outpatient procedure by injecting local anesthesia with an insulin needle. The surgeon drains and opens the cyst with a surgical blade, laser, or electrocautery and tries to remove the cyst wall or capsule as well.
If only the cyst is drained and the cyst wall is not removed properly, the cyst may recur after some time.

Benign and Malignant Skin Lesions of the Genital Area

Skin diseases in the male genital area are very diverse. These lesions can include fungal and parasitic infections around the anus or groin, as well as skin lesions on the penis. Sometimes several different conditions look very similar, and an accurate, definitive diagnosis is not possible without a careful examination and sometimes a biopsy.

For diagnosis, the doctor performs a physical examination and evaluates lesions or lumps on the skin. The doctor may also recommend a biopsy.

A specialist can choose the best treatment method after observing and evaluating the lesion; treatment options are often similar. These treatments include cryotherapy (freezing therapy), vessel ligation, laser treatment, and surgery. During surgery, the doctor can remove genital warts and skin lesions with a scalpel.