Pd46-03 Exploring Local Anesthesia Exclusively for Penile and Scrotal Procedures: A Prospective Study on Patient Comfort and Surgical Effectiveness as a Sedation-Free Option

You have accessJournal of UrologySexual Function/Dysfunction: Surgical Therapy I (PD46)1 May 2024PD46-03 EXPLORING LOCAL ANESTHESIA EXCLUSIVELY FOR PENILE AND SCROTAL PROCEDURES: A PROSPECTIVE STUDY ON PATIENT COMFORT AND SURGICAL EFFECTIVENESS AS A SEDATION-FREE OPTION Dhiraj S. Bal, Jainik Shah, Maximilian Fidel, Matthew Urichuk, and Premal Patel Dhiraj S. BalDhiraj S. Bal , Jainik ShahJainik Shah , Maximilian FidelMaximilian Fidel , Matthew UrichukMatthew Urichuk , and Premal PatelPremal Patel View All Author Informationhttps://doi.org/10.1097/01.JU.0001008900.49567.2e.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Urologic procedures traditionally rely on spinal or general anesthesia (GA) in a hospital operating room, posing high costs and accessibility challenges. Particularly, penile and scrotal procedures suffer from extended wait times as they are often treated non-urgently. Recent literature has shown interest in using local anesthesia (LA) alone, but patient tolerability remains unexamined. Our study aims to assess the patient experience of penile and scrotal urologic procedures performed solely under LA, gathering data on outcomes and complications for a safer, cost effective sedation-free alternative. METHODS: Between August 2022 and 2023, adult patients were prospectively enrolled in this clinical trial (NCT05617261). All patients underwent penile or scrotal surgery after being administered LA along the median raphe and with a spermatic cord block or a subcutaneous ring and dorsal nerve block. Demographics, surgeon- and patient-reported visual analogue pain scores (VAS), and surgical variables were collected. Our primary outcomes, future anesthetic choice for a repeat procedure and overall experience (likert scale 1-10; 1=best, 10=worst), were obtained at a follow-up appointment. Complication data including recurrence, emergency room visits, excess pain, hematoma & infection are reported. RESULTS: A total of 107 patients were enrolled, with mean age±SD of 42.2±16.4 years. All procedures were successful, with no perioperative complications or conversations to sedation or GA. 80% (84/105) of patients reports that they would choose LA over GA if they needed to repeat the procedure (Figure 1). Patients preferring GA over LA mostly desired no memory of the procedure, rather than having high levels of pain. On univariate analyses, longer procedure duration (+0.59; CI95=[0.20-0.98]; p=0.003), cannabis use (+1.90, CI95=0.40-3.40; p=0.01) and higher intra-operative pain (+0.45; CI95=0.14-0.77; p=0.005) were associated with lower ratings of overall experience. CONCLUSIONS: LA only is a promising technique for various scrotal and penile urologic procedures with high levels of patient tolerability. Given minimal complications with this approach, we recommend its adoption as we anticipate significant cost savings with a substantial reduction in patient wait times, surgical and recovery times – allowing for increased surgical efficiency and accessibility. Download PPT Source of Funding: N/A © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e974 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Dhiraj S. Bal More articles by this author Jainik Shah More articles by this author Maximilian Fidel More articles by this author Matthew Urichuk More articles by this author Premal Patel More articles by this author Expand All Advertisement PDF downloadLoading ...