title: Intraoperative penile erection.
abstract: OBJECTIVE
  Penile erection following epidural anesthesia is an infrequent occurrence of unclear etioogy. It is very troublesome to perform the procedure during penile erection and attempting it leads to various complications. Three such cases are reported herein. The literature on the pathophysiology and management of intraoperative penile erection is discussed.
  
  
  METHODS
  Eighteen hundred patients who received epidural anesthesia for various transurethral procedures like cystoscopy, ureterorenoscopy, transurethral resection of prostate and bladder tumors form the clinical material.
  
  
  RESULTS
  Out of 1800 cases, we have encountered penile erection only in three cases. Two cases were managed with local application of cold saline and cold sponging followed by terbutaline. The third case could be managed with local application of cold saline and cold sponging of scrotum and penis. Afterwards the procedure could be performed safely.
  
  
  CONCLUSIONS
  The pathophysiology and management of intraoperative penile erection is poorly understood. With the onset of erection during an operative procedure, the anesthesiologist must quickly initiate the therapy, as duration of erection is the critical factor in the detumescence of the penis.
authors.affiliation: Department of Urology and Anaesthesia, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, UP, India. hsgrao@hotmail.com
authors.forename: T H
authors.initials: TH
authors.lastname: Rao
authors.forename: W
authors.initials: W
authors.lastname: Zaman
authors.forename: R K
authors.initials: RK
authors.lastname: Jain
mesh_terms: D000328:Adult; D000767:Anesthesia, Epidural / Q000009:adverse effects*; D006801:Humans; D007431:Intraoperative Complications / Q000503:physiopathology; D008297:Male; D010410:Penile Erection / Q000187:drug effects*