Dorsal Slit Procedure

Why is it done?

• Paraphimosis: foreskin stuck behind head of penis.
• Foreskin preserving.

How is it done?

• This is done under general anesthetic or a penile block.
• A vertical cut is made through the tightest part of the para-phimosis, and the foreskin is than able to be covered over the meatus.
• The incision is then closed by opposing edges in the horizontal plane.
• Dissolvable sutures are placed between the 2 remaining edges.
• A local anesthetic is injected into the base of the penis thus giving post-operative pain relief for the next 4-6 hours.

What to expect after the procedure

• Any anesthetic has its risks, and the anesthetist will explain such risks.
• Minor bleeding.
• With any subsequent erections post operatively, the sutures may pull out causing an opening of the wound with subsequent bleeding.
• An infection of the wound can occur if the dressings are left on too long.
• If the dressing has been applied too tightly, or if there is any discomfort, please remove the dressing immediately. If some hemorrhaging re-occurs, REDO the dressing!
• In very young patients, the foreskin may still be attached to the head of the penis, thus leaving a raw and red glans penis after surgery. Keep the affected area clean and apply ointment as prescribed.
• NB! Each person is unique and for this reason symptoms may vary!

What next?

• The dressing should be removed in a bath 48 hours after the procedure.
• The dressing should be soaked until it comes off with ease.
• The dressing may sometimes adhere to the wound causing slight bleeding on removal. Don’t panic the bleeding will stop.
• As soon as the dressing has been removed, Bactroban (or similar) ointment should be applied on the wound twice a day.
• This may not be required if the foreskin was not adhered to the glans penis.
• On discharge a prescription may be issued for the patient to collect.
• A follow-up appointment should be scheduled to see Dr Schoeman within 2 weeks.
• Please don’t hesitate to direct all pre-operative queries to Dr Schoeman’s rooms.
• PLEASE CONTACT THE HOSPITAL WITH ANY POST-OPERATIVE CONCERNS AND RETURN TO THE HOSPITAL IMMEDIATELY SHOULD THERE BE ANY SIGNS OF SEPSIS.

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Wes Dorsal Slit procedure