Effect of Pudendal Nerve Block on the Prevention of Postoperative Bladder Spasm and Catheter-Related Bladder Discomfort in Male Patients Undergoing Transurethral Holmium Laser Enucleation of the Prostate
Sheng-Yan Wang,1 Qing Qiu,2 Xu Shen1 1Medical Center for Anesthesia and Pain, First Hospital of Jiaxing, Jiaxing City, People’s Republic of China; 2Anesthesia Medicine, Zhejiang Chinese Medical University, Hangzhou City, People’s Republic of ChinaCorrespondence: Xu Shen, Email 00181787@zjxu.edu.cnPu...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2022-11-01
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| Series: | Clinical Interventions in Aging |
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| Online Access: | https://www.dovepress.com/effect-of-pudendal-nerve-block-on-the-prevention-of-postoperative-blad-peer-reviewed-fulltext-article-CIA |
| _version_ | 1811321401156567040 |
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| author | Wang SY Qiu Q Shen X |
| author_facet | Wang SY Qiu Q Shen X |
| author_sort | Wang SY |
| collection | DOAJ |
| description | Sheng-Yan Wang,1 Qing Qiu,2 Xu Shen1 1Medical Center for Anesthesia and Pain, First Hospital of Jiaxing, Jiaxing City, People’s Republic of China; 2Anesthesia Medicine, Zhejiang Chinese Medical University, Hangzhou City, People’s Republic of ChinaCorrespondence: Xu Shen, Email 00181787@zjxu.edu.cnPurpose: Bladder spasm (BS) and catheter-related bladder discomfort (CRBD) are complications after transurethral holmium laser enucleation of the prostate (HoLEP). The pudendal nerve (PN) innervates the perineum. Therefore, we evaluated whether PN block (PNB) can reduce the incidence of BS and CRBD in patients undergoing HoLEP.Methods: In this randomized, parallel, single-blind prospective study, we enrolled 110 patients who were scheduled to undergo HoLEP under general anesthesia. Patients were randomly allocated to the PNB group (ultrasound-guided PNB at the entrance of the pudendal [Alcock’s] canal bilaterally; n = 55) or the control group (general anesthesia only; n = 55). The primary outcome was the incidence of BS and CRBD at 0.5, 1, 2, 4, 6, 12, and 24 hours postoperatively. The CRBD severity, postoperative pain, and analgesic drug use were also assessed. A P value of < 0.05 was considered statistically significant.Results: A significantly lower incidence of BS (P = 0.023) and CRBD (P < 0.001) was reported within the first 24 hours postoperatively in the PNB group. The incidence of CRBD above a moderate grade at 0.5 (P < 0.001), 1 (P < 0.001), 2 (P < 0.001), and 4 (P = 0.019) hours postoperatively was significantly lower in the PNB group. Additionally, postoperative pain scores and analgesic drug use were significantly lower in the PNB group. No PNB-related complications were observed.Conclusion: PNB at the entrance of the pudendal canal bilaterally resulted in a lower incidence of BS and CRBD, less postoperative pain, and less analgesic drug use in patients undergoing HoLEP without PNB-related side effects.Implication Statement: Bladder spasm and catheter-related bladder discomfort can occur in older individuals undergoing transurethral holmium laser enucleation of the prostate. They often result in severe pain and prolonging the hospital stay. We performed a bilateral ultrasound-guided pudendal nerve block at the entrance of the pudendal (Alcock’s) canal and found that the block reduced bladder spasm, catheter-related bladder discomfort, postoperative pain, and use of anesthetics. Besides, pudendal nerve block also decreased the severity of catheter-related bladder discomfort and helped older individuals achieve rapid recovery.Keywords: transurethral holmium laser enucleation of the prostate, pudendal nerve block, bladder spasm, catheter-related bladder discomfort, pudendal (Alcock’s) canal |
| first_indexed | 2024-04-13T13:17:07Z |
| format | Article |
| id | doaj.art-3e29e7eca5aa452498fc4ddbf42423c0 |
| institution | Directory Open Access Journal |
| issn | 1178-1998 |
| language | English |
| last_indexed | 2024-04-13T13:17:07Z |
| publishDate | 2022-11-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Clinical Interventions in Aging |
| spelling | doaj.art-3e29e7eca5aa452498fc4ddbf42423c02022-12-22T02:45:26ZengDove Medical PressClinical Interventions in Aging1178-19982022-11-01Volume 171729173880004Effect of Pudendal Nerve Block on the Prevention of Postoperative Bladder Spasm and Catheter-Related Bladder Discomfort in Male Patients Undergoing Transurethral Holmium Laser Enucleation of the ProstateWang SYQiu QShen XSheng-Yan Wang,1 Qing Qiu,2 Xu Shen1 1Medical Center for Anesthesia and Pain, First Hospital of Jiaxing, Jiaxing City, People’s Republic of China; 2Anesthesia Medicine, Zhejiang Chinese Medical University, Hangzhou City, People’s Republic of ChinaCorrespondence: Xu Shen, Email 00181787@zjxu.edu.cnPurpose: Bladder spasm (BS) and catheter-related bladder discomfort (CRBD) are complications after transurethral holmium laser enucleation of the prostate (HoLEP). The pudendal nerve (PN) innervates the perineum. Therefore, we evaluated whether PN block (PNB) can reduce the incidence of BS and CRBD in patients undergoing HoLEP.Methods: In this randomized, parallel, single-blind prospective study, we enrolled 110 patients who were scheduled to undergo HoLEP under general anesthesia. Patients were randomly allocated to the PNB group (ultrasound-guided PNB at the entrance of the pudendal [Alcock’s] canal bilaterally; n = 55) or the control group (general anesthesia only; n = 55). The primary outcome was the incidence of BS and CRBD at 0.5, 1, 2, 4, 6, 12, and 24 hours postoperatively. The CRBD severity, postoperative pain, and analgesic drug use were also assessed. A P value of < 0.05 was considered statistically significant.Results: A significantly lower incidence of BS (P = 0.023) and CRBD (P < 0.001) was reported within the first 24 hours postoperatively in the PNB group. The incidence of CRBD above a moderate grade at 0.5 (P < 0.001), 1 (P < 0.001), 2 (P < 0.001), and 4 (P = 0.019) hours postoperatively was significantly lower in the PNB group. Additionally, postoperative pain scores and analgesic drug use were significantly lower in the PNB group. No PNB-related complications were observed.Conclusion: PNB at the entrance of the pudendal canal bilaterally resulted in a lower incidence of BS and CRBD, less postoperative pain, and less analgesic drug use in patients undergoing HoLEP without PNB-related side effects.Implication Statement: Bladder spasm and catheter-related bladder discomfort can occur in older individuals undergoing transurethral holmium laser enucleation of the prostate. They often result in severe pain and prolonging the hospital stay. We performed a bilateral ultrasound-guided pudendal nerve block at the entrance of the pudendal (Alcock’s) canal and found that the block reduced bladder spasm, catheter-related bladder discomfort, postoperative pain, and use of anesthetics. Besides, pudendal nerve block also decreased the severity of catheter-related bladder discomfort and helped older individuals achieve rapid recovery.Keywords: transurethral holmium laser enucleation of the prostate, pudendal nerve block, bladder spasm, catheter-related bladder discomfort, pudendal (Alcock’s) canalhttps://www.dovepress.com/effect-of-pudendal-nerve-block-on-the-prevention-of-postoperative-blad-peer-reviewed-fulltext-article-CIAtransurethral holmium laser enucleation of the prostatepudendal nerve blockbladder spasmcatheter-related bladder discomfortpudendal (alcock’s) canal |
| spellingShingle | Wang SY Qiu Q Shen X Effect of Pudendal Nerve Block on the Prevention of Postoperative Bladder Spasm and Catheter-Related Bladder Discomfort in Male Patients Undergoing Transurethral Holmium Laser Enucleation of the Prostate Clinical Interventions in Aging transurethral holmium laser enucleation of the prostate pudendal nerve block bladder spasm catheter-related bladder discomfort pudendal (alcock’s) canal |
| title | Effect of Pudendal Nerve Block on the Prevention of Postoperative Bladder Spasm and Catheter-Related Bladder Discomfort in Male Patients Undergoing Transurethral Holmium Laser Enucleation of the Prostate |
| title_full | Effect of Pudendal Nerve Block on the Prevention of Postoperative Bladder Spasm and Catheter-Related Bladder Discomfort in Male Patients Undergoing Transurethral Holmium Laser Enucleation of the Prostate |
| title_fullStr | Effect of Pudendal Nerve Block on the Prevention of Postoperative Bladder Spasm and Catheter-Related Bladder Discomfort in Male Patients Undergoing Transurethral Holmium Laser Enucleation of the Prostate |
| title_full_unstemmed | Effect of Pudendal Nerve Block on the Prevention of Postoperative Bladder Spasm and Catheter-Related Bladder Discomfort in Male Patients Undergoing Transurethral Holmium Laser Enucleation of the Prostate |
| title_short | Effect of Pudendal Nerve Block on the Prevention of Postoperative Bladder Spasm and Catheter-Related Bladder Discomfort in Male Patients Undergoing Transurethral Holmium Laser Enucleation of the Prostate |
| title_sort | effect of pudendal nerve block on the prevention of postoperative bladder spasm and catheter related bladder discomfort in male patients undergoing transurethral holmium laser enucleation of the prostate |
| topic | transurethral holmium laser enucleation of the prostate pudendal nerve block bladder spasm catheter-related bladder discomfort pudendal (alcock’s) canal |
| url | https://www.dovepress.com/effect-of-pudendal-nerve-block-on-the-prevention-of-postoperative-blad-peer-reviewed-fulltext-article-CIA |
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