Dorsal Penile Nerve Block for Rigid Cystoscopy in Men
Dorsal Penile Nerve Block for Rigid Cystoscopy in Men
This study will determine the effectiveness and safety of dorsal penile nerve block (DPNB) in
 men undergoing rigid cystoscopy.
Pain is common in men undergoing rigid cystoscopy. Even with application of a lubricant
 containing 2% lidocaine, about 76% men suffer from mild to severe pain when undergoing rigid
 cystoscopy, and approximately 27% men could still feel mild to moderate pain 7 days after the
 procedure. The most painful part of the procedure for men is when the cystoscope passes
 through the membranous urethra. Song et al did autopsy on males found dorsal nerve of the
 penis (DNP), the terminal branch of the pudendal nerve, innervates the membranous urethra in
 53.3% specimens. In addition, urethral mucosa has branches of DNP innervated. Dorsal penile
 nerve block (DPNB) is usually used for circumcision in children and it has been shown to
 provide effective analgesia for penile surgeries. According to the evidence that some DNP
 branches innervate membranous urethra and urethra mucosa and most pain originates from
 cystoscope passing through membranous urethra, we speculated that DPNB could overall reduce
 pain level in men during rigid cystoscopy.
Inclusion Criteria:

 -  American Society of Anesthesiologists (ASA) Physical Status I-II

 -  Without history of urethral or prostatic surgery

 -  Without respiration or circulation disorders

 -  Without chronic pain

 Exclusion Criteria:

 -  Allergy to local anesthetics

 -  Coagulation disorder or usage of antiplatelet drugs

 -  Infection at the site of puncture point

 -  Severe urethral stenosis