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Re: Circs - Peds or OB? (no politics please...)From: Ealgail (Ealgail@aol.com)Wed Apr 1 14:35:20 1998
In a message dated 98-03-30 19:38:43 EST, you write:
<< he flip side of this is, who's the surgical subspecialist, to handle
complications of surgery? Not the pediapod... So you can argue both ways.
>> I agree. When there is complication, even as minor as the foreskin sticking to the glans, in my experience, the Peds do not have any answers or the right answer. Also, there have been circs in programs where too much, too little, or a crooked cut is done by our learning physicians, whether Peds or Obs. The answer is NOT to wait until they are two years old and have a Urologist fix it under general anesthesia, which is what our senior Peds physicians usually tell parents. Often, with a different instrument, usually a Mogen, these babies can be "re-done" to correct the problem. I use a Mogen (but have also used the Sheldon, the Plasti-bell, and the Gomco) and I do a dorsal penile block using a 30 ga needle and 1% plain lidocaine; about 0.2 cc on each side at 2 and 10 o'clock, and try to wait about 5 min. Linda Linda Morrison-Boczar, MD. MBA, FACOG Sarasota, FL
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