Mp43-03 Schelin Catheter Transurethral Intraprostatic Anesthesia Monotherapy: New Standard for Outpatient, Office-Based Anesthesia

You have accessJournal of UrologySurgical Technology & Simulation: Instrumentation & Technology II (MP43)1 May 2024MP43-03 SCHELIN CATHETER TRANSURETHRAL INTRAPROSTATIC ANESTHESIA MONOTHERAPY: NEW STANDARD FOR OUTPATIENT, OFFICE-BASED ANESTHESIA Aalya Hamouda, Ahmed Ibrahim, Nicholas Corsi, Giampaolo Siena, Dean S. Elterman, Bilal Chughtai, Naeem Bhojani, Francesco Sessa, Anna Rivetti, Silvia Secco, and Kevin C. Zorn Aalya HamoudaAalya Hamouda , Ahmed IbrahimAhmed Ibrahim , Nicholas CorsiNicholas Corsi , Giampaolo SienaGiampaolo Siena , Dean S. EltermanDean S. Elterman , Bilal ChughtaiBilal Chughtai , Naeem BhojaniNaeem Bhojani , Francesco SessaFrancesco Sessa , Anna RivettiAnna Rivetti , Silvia SeccoSilvia Secco , and Kevin C. ZornKevin C. Zorn View All Author Informationhttps://doi.org/10.1097/01.JU.0001008720.96896.83.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Minimally invasive surgeries (MIS), such as Rezūm treatment (RT) for Benign Prostatic Hyperplasia (BPH), are gaining prominence. Standard analgesia involves peri-prostatic nerve block (PNB) with transrectal ultrasound (TRUS) or sedation. TRUS is invasive, uncomfortable, and carries infectious risks. Other methods demand time, training, pose safety risks, or require anesthesiology. Transurethral intraprostatic anesthesia (TUIA) using the Schelin Catheter (ProstaLund AB, Sweden) (SC) is a non-invasive technique. We aimed to evaluate the analgesic efficacy of SC in patients undergoing RT. Secondly, we compared these results with a pilot study of TRUS-guided PNB. METHODS: Ten consecutive patients from a single surgeon (KCZ) and outpatient clinic were recruited based on history, physical exam, and measures for lower urinary tract symptoms (LUTS) and BPH assessment. This included the International Prostate Symptom Score (IPSS), quality of life (QoL), prostate volume, serum prostate-specific antigen (PSA), urodynamic evaluation (maximum urinary flow rate (Qmax); post-void residual (PVR)). Lidocaine 2% was injected in four quadrants around the prostate base. Pain was measured using the Visual Analogue Scale (VAS) at five timepoints: baseline, after SC (before Rezūm scope insertion), immediately after Rezūm scope insertion, during RT, and immediately after case completion. Results were compared with TRUS PNB from a prior study with the same methods. RESULTS: Baseline characteristics included median age of 67 years (range 55-92) and prostate volume of 97 cc (45-156). 40% of subjects had baseline retention and 70% had a median lobe. Median Qmax was 4.9 mL/s (1.7-8.2) and PVR was 298.5 mL (181-720). Median IPSS was 29 (23-35) and QoL was 5 (4-6). The median time for RT was 4 minutes 27 seconds (3 min 45s – 6 min 57s) with 8 injections (6-20). VAS score (mean±SD) at each timepoint was 0.0±0.0, 1.3±0.48, 1.3±0.48, 3.0±0.67, and 1.1±0.57. SC demonstrated lower scores compared to TRUS PNB immediately after Rezūm scope insertion (p<0.001), during RT (p<0.001), and immediately after case completion (p<0.05). CONCLUSIONS: Our results demonstrate that SC effectively managed pain and suggests that TUIA is superior to TRUS PNB. TUIA shows potential in being effective, non-invasive, and cost-efficient. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e693 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Aalya Hamouda More articles by this author Ahmed Ibrahim More articles by this author Nicholas Corsi More articles by this author Giampaolo Siena More articles by this author Dean S. Elterman More articles by this author Bilal Chughtai More articles by this author Naeem Bhojani More articles by this author Francesco Sessa More articles by this author Anna Rivetti More articles by this author Silvia Secco More articles by this author Kevin C. Zorn More articles by this author Expand All Advertisement PDF downloadLoading ...