title: Acupuncture assisted local anesthesia for penile surgeries.
abstract: Although the mechanism of acupuncture for analgesia is not fully elucidated, a combination of acupuncture and several methods of topical blocks for local anesthesia has been effective to patients with indications for penile surgeries on ambulatory basis. We sought to review this unique clinical application since 1998. To summarize practice-based medical literature contingent this unique application and, in contrast, the commonly agreed either general or spinal anesthesia concerning those surgeries on this most sensitive organ-the delicate penis. From July 1998 to July 2013, total of 1,481 males underwent penile surgeries with specific topical nerve blockage in addition to acupuncture in which the acupoints of Hegu (LI4), Shou San Li (LI10), Quchi (LI11), and either Waiguan (TE5) or Neiguan (PC6) were routinely used. Careful anesthetic block of the paired dorsal nerve in the penile hilum associated with a peripenile infiltration was categorized to method I which is sufficient to anesthetize the penile structures for varied penile surgeries including 993 men of penile venous stripping surgeries, 336 cases of penile corporoplasty, 8 males of urethroplasty, 7 patients of vaso-vasostomy, 6 men of penile arterial reconstruction and 3 surgeries of penectomy. Whereas the bilateral cavernous nerve block and crural blockage were indispensably added up for anesthetizing the sinusoids of the corpora cavernosa (CC) for penile implant of varied model. It was allocated to method II and had been applied in 125 males. A further topical injection of the medial low abdominal region made it possible for implanting a three-piece model in three males. Thus recent discoveries and better understanding of the penile anatomy had been meaningful in the development and improvement of specific nerve blockade techniques for penile surgeries in particularly adding up with acupuncture techniques, while minimizing anesthetic adverse effects and resulting in a rapid return to daily activity with minimal complications.
authors.affiliation: Microsurgical Potency Reconstruction and Research Center, Hsu's Andrology and National Taiwan University, Taipei, Taiwan ;
authors.forename: Geng-Long
authors.initials: GL
authors.lastname: Hsu
authors.affiliation: Department of Urology, University of California San Francisco, USA ;
authors.forename: Uwais X
authors.initials: UX
authors.lastname: Zaid
authors.affiliation: Division of Urology, Buddhist Tzu-Chi General Hospital, Taipei Branch, School of Medicine, Buddhist Tzu-Chi University, Hualien, Taiwan ;
authors.forename: Cheng-Hsing
authors.initials: CH
authors.lastname: Hsieh
authors.affiliation: National Taiwan University Hospital, Jin-Shan Branch, New Taipei, Taiwan.
authors.forename: Sheng-Jean
authors.initials: SJ
authors.lastname: Huang
keywords: Acupuncture-aided local anesthesia; cavernous nerve block; crural block; proximal dorsal nerve block; topical injection
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