How to Perform an IPP Under Local Anesthesia

Park, S.H.

Objective: To demonstrate first time inflatable penile prosthesis surgery either subcoronal or scrotal approach under local anesthesia

Material: 66 years old Korean man with medicine non-responsive ED had first time inflatable penile prosthesis surgery under local anesthesia in Jan. 23rd, 2018

Methods: 0.3cc Trimix was injected preoperatively to relax corpora. Step wise local anesthesia was done; right before the surgery: Pudendal, Penile root, Rt. Inguinal canal. During the course of the surgery: Rt. Superficial inguinal ring under direct vision and each proximal corpora where incision was placed. Foley catheter was placed. Subcoronal approach was utilized and scrotal wall block was also demonstrated. Modified Wilson's deaver maneuver was done to prevent postop tubing protrusion. Measured Corporal length was 19 cm. 65cc Spherical reservoir was placed to Rt. Space of Retzius followed by placement of 18cm AMS CX cylinders with 1 cm RTE. Penile skin was repaired in 2 layer fashion. Compression dressing was applied.

Results: Total 34cc of 1% lidocaine & 0.75% Ropivacaine mixture was injected. Subjective pain scale during the surgery was 1. OR time was 54 minutes. No notable complication was reported.

Conclusion: IPP placement could be performed under local anesthesia with minimal patient discomfort.