• G M vd Berg, S Lillieborg, and E Stolz.
• Department of Dermatovenereology, University Hospital Rotterdam/Dijkzigt, The Netherlands.
• Genitourin Med. 1992 Jun 1;68(3):162-5.

ObjectivesTo compare analgesic efficacy and pain caused by administration of lidocaine/prilocaine cream (EMLA(R)) versus xylocaine 1% local infiltration for punch biopsy and electrocoagulation of genital warts in men.DesignOpen randomised comparative parallel-group study.SettingDepartment of Dermatovenereology, University Hospital Rotterdam/Dijkzigt, the Netherlands.Patients63 males with warts on the genital mucosa and/or perianal area.MethodsEMLA(R) cream (2.5-5 g) was applied during 13-45 minutes before surgery. Xylocaine 1% (0.1-4 ml) was infiltrated 0.5-4 minutes before surgery. Pain during administration and surgery was assessed by the patient on a verbal rating scale and on a visual analogue scale.ResultsEMLA(R) application was painless in all patients (n = 31) whereas xylocaine infiltration was slightly painful in 17/29 patients and moderately painful in 10/29 patients. EMLA(R) analgesia was satisfactory for 94% of biopsies and 62% of electrocoagulations. Xylocaine infiltration was satisfactory in all procedures.ConclusionsEMLA(R) application on the male genital mucosa is painless but it has a lower analgesic efficacy than xylocaine infiltration. However EMLA is a useful anaesthetic for taking biopsies in this area and may be used as premedication for local infiltration.

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