[Pudendal nerve block: local anaesthesia for insertion of suburethral tape: preliminary study of 9 cases].
OBJECTIVE
The objective of this study is to evaluate the safety of local anaesthesia by pudendal nerve block (PNB) for insertion of TVT or TOT suburethral tape for the treatment of female urinary incontinence.


METHODS
PNB is performed by bilateral injection between the anus and ischium. The pudendal nerve, detected by electrostimulation, is anaesthetised by a solution of Naropeine and Carbocaine. Anaesthesia is systematically completed by abdominogenital and genitofemoral nerve blocks and by deep infiltration in the vagina. Perioperative and postoperative pain was assessed by visual analogue scale (VAS).


RESULTS
Nine patients were treated by suburethral tape under PNB between November 2002 and January 2003. The mean age was 65.5 years (range: 46 to 87 years). TVT was used in 6 cases and TOT was used in 3 cases. PNB was well tolerated by the patient in 66% of cases. Eight patients (88%) did not experience any pain during the operation. The majority of patients (88%) were very satisfied with the anaesthesia. One patient experienced residual pain for 3 weeks. The technique is easy to perform by the anaesthetist and did not modify the surgical technique. This technique is relatively inexpensive.


CONCLUSIONS
This preliminary study on a limited number of cases shows that PNB appears to be a good alternative to the usual anaesthesia techniques for insertion of suburethral tape.
Darcq
Clément
C
Service de Gynécologie-Obstétrique, Centre Hospitalier Paul Ardier, Issoire, France. clement.darcq@wanadoo.fr
Ayadi
Mohamed
M
Dissait
Véronique
V
Piech
Jean-Jacques
JJ
Anton-Bousquet
Marie-Claude
MC
Mansoor
Aslam
A
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008875:Middle Aged; D009407:Nerve Block; D010149:Postoperative Pain / Q000209:etiology / Q000517:prevention & control*; D019736:Prostheses and Implants; D014549:Urinary Incontinence / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000009:adverse effects