title: Outpatient penile implantation with the patient under a novel method of crural block.
abstract: Although local anaesthesia for penile implants has been substantially reported, its methodology, simplicity and reliability left room for improvement. We would like to report on an innovative penile crural block using local anaesthesia in patients who underwent penile implantation as outpatient surgery. From March 1987 to March 1991, a total of 21 organically impotent men, aged from 27 to 77 years, received penile prosthesis implantation. All these were performed under pudendal nerve block as an outpatient procedure. From August 1992 to January 2003 a proximal dorsal nerve block with peripenile infiltration and penile crural block was developed to replace the anaesthesia method of pudendal nerve blocks in 137 consecutive patients (aged from 35 to 83 years) undergoing penile implants. The anaesthetic effects and postoperative results with the crural block were very satisfactory. Common immediate side-effects included puncture of the vessels, subcutaneous ecchymosis, transient palpitations and dilation pain, but there were no significant late complications. In the group of pudendal nerve blockage, 42.9% patients (nine of 21) experienced severe aching pain over the perineum for 1-2 weeks postoperatively, whereas the newly developed method of crural block markedly reduced these adverse effects. This new anaesthetic method proved to be reliable, simple, and safe with fewer complications. It offers the advantages of less morbidity, preservation of patient's privacy, reduced adverse effects of anaesthesia, and a more-rapid return to activity with minimal complications.
authors.affiliation: Microsurgical Potency Reconstruction Center, Taiwan Adventist Hospital, Taipei Medical University, Taiwan. glhsu@tahsda.org
authors.forename: Geng-Long
authors.initials: GL
authors.lastname: Hsu
authors.forename: Cheng-Hsing
authors.initials: CH
authors.lastname: Hsieh
authors.forename: Hsien-Sheng
authors.initials: HS
authors.lastname: Wen
authors.forename: Shyh-Chyan
authors.initials: SC
authors.lastname: Chen
authors.forename: Yi-Chang
authors.initials: YC
authors.lastname: Chen
authors.forename: Li-Jen
authors.initials: LJ
authors.lastname: Liu
authors.forename: Martin S
authors.initials: MS
authors.lastname: Mok
authors.forename: Chih-Hsiung
authors.initials: CH
authors.lastname: Wu
mesh_terms: D000328:Adult; D000368:Aged; D000556:Ambulatory Surgical Procedures; D000772:Anesthesia, Local; D007172:Erectile Dysfunction / Q000601:surgery; D006801:Humans; D008012:Lidocaine; D008297:Male; D008875:Middle Aged; D009407:Nerve Block; D019935:Penile Implantation / Q000379:methods* / Q000706:statistics & numerical data; D015917:Penile Prosthesis; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D008012:Lidocaine