Title: How to Perform a Revision IPP Under Local Anesthesia
Author: Sun Hung Park
Objective: To demonstrate revision inflatable penile prosthesis surgery through subcoronal approach under local anesthesia
Material: 68 years old Korean man who had an revision IPP surgery because of dissatisfaction due to previous under sizing, Dec 19th, 2017
Methods: Local anesthesia was done similar to first time implant case; Pethidine 25mg IM right before the surgery; Pudendal, Penile root, Rt. Inguinal canal block were done. During the course of the surgery conscious sedation with Propofol® was added to enhance patient comfort. Foley catheter was placed. Though subcoronal approach, previous CXR 16cm cylinders and pump were removed. Reservoir was drained & retained. Due to previous under sizing, proximal pseudo capsule was perforated with backward cutting scissors. 65cc Spherical reservoir was placed to Rt. Space of Retzius. Newly measured corporal length was 20cm and 18cm AMS CX cylinders with 2 cm RTE was implanted. Suction drain was placed Lt. side of prepubic area. Penile skin was repaired in 2 layer fashion. Compression dressing was applied.
Results: Total 30cc of 1% lidocaine & 0.75% Ropivacaine mixture was injected. OR time was 65 minutes. Postop subjective pain score of immediate postop was 2 and POD#1 was 3 respectively.
Conclusion: Revision IPP surgery could be done under local anesthesia with conscious sedation with minimal patient discomfort.