Pediatric office procedures.

The practice of pediatric urology has changed much during the last 25 years. Procedures that were once done only on inpatients are now done as ambulatory cases, comprising more than 60 per cent of all surgery. This trend has continued, with even more cases being done as office procedures. These consist of circumcision, meatotomy for stenosis, lysis of labial adhesions, and meatal dilatation after hypospadias repair. If an operation is done with attention to detail, it can be completed with minimal complications, although, as evidenced with circumcision, those that do occur can carry significant morbidity and even cause death. The primary limiting factor for performing procedures in the office is the comfort of the patient. The procedure, by necessity, has to entail minimum pain and great ease in obtaining hemostasis and requires a cooperative patient and family. Therefore, even as the number of operations performed on an out-patient basis increases, there are a finite number of cases suitable for the office.