Pudendal and Dorsal Penile Nerve Blocks during Inflatable Penile Prosthesis Implantation

El-Khatib, F.M, Liaw, A, Loeb, A, Nguyen, J.T, Simhan, J, Yafi, F

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.

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