Word from The Editor-In-Chief

It is with great pride that I welcome you to participate in the Journal of Prosthetic Urology (VJPU). The journal was created by the ISSM to serve as a forum for sexual medicine to allow its members to exchange notable ideas via the visual medium. Our members are scattered across the globe and prosthetic urology is a tiny subspecialty of sexual medicine. A specific goal was to facilitate the transmission of surgical technique knowledge regarding the implantation of surgical devices related to sexual medicine.

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Pudendal and Dorsal Penile Nerve Blocks during Inflatable Penile Prosthesis Implantation

Authors: Farouk M. El-Khatib¹, Aron Liaw¹, Charles A. Loeb¹, Jeanie T. Nguyen¹, Jay Simhan², Faysal A. Yafi¹

1- Department of Urology, University of California Irvine, Orange, CA, USA
2- Department of Urology, Einstein Healthcare Network, Philadelphia, PA, USA

Keywords: pudendal nerve, dorsal penile nerve, nerve blocks, penile prosthesis

Pudendal nerve blocks (PNB) have historically been used as regional anesthesia during obstetric procedures, but not as much for urological procedures [1]. While dorsal penile nerve blocks (DPNB) can be used for a variety of urethral surgeries and repair of penile lacerations [2]. In a large, multicenter patient cohort undergoing Inflatable Penile Prosthesis (IPP) implantation whose pain was managed using a multimodal analgesia (MMA) protocol, results showed that patients adhering to this protocol had significantly lower postoperative pain measures, significantly lower usage of narcotics (both inpatient and outpatient), without any discernable side effects [3]. Both PNB and DPNB were part of the MMA protocol. This video demonstrates our easily reproducible technique of performing these procedures pre-operatively in the setting of our MMA protocol. In conclusion, dorsal penile and pudendal nerve blocks are simple and safe procedures that may offer better pain control to patients undergoing penile prosthesis implantation.

Acknowledgements: None

Disclosures: Antares Pharma: Advisory board, speaker. Coloplast: Advisory board, consultant. Endo Pharmaceuticals: Advisory board, speaker. Viome: Research grant primary investigator

References

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Rose G, Costa V, Drake A, Siadecki S. Ultrasound-guided dorsal penile nerve block performed in a case of zipper entrapment injury. J Clin Ultrasound.45:589–591. https://doi.org/10.1002/jcu.22459

Lucas J, Gross M, Yafi F, et al. A Multi-institutional Assessment of Multimodal Analgesia in Penile Implant Recipients Demonstrates Dramatic Reduction in Pain Scores and Narcotic Usage. J Sex Med. 2020;17(3):518‐ doi:10.1016/j.jsxm.2019.11.267