https://doi.org/10.4081/aiua.2024.12951

Comparative study between intrathecal fentanyl and dorsal penile nerve block for controlling postoperative pain after inflatable penile prosthesis implantation

Early Access
Submitted: August 21, 2024
Accepted: September 2, 2024
Published: October 29, 2024
Inflatable penile prosthesis, Pain control, Erectyle dysfunction
Abstract Views: 147
PDF: 21
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Authors

Adel Elatreisy
adel.elatreisy@azhar.edu.eg
https://orcid.org/0000-0001-8407-0564
Urology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Yasser Ahmed
https://orcid.org/0009-0007-5110-727X
Urology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Ahmed Elgarhy
Anesthesia Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Mohamed Hindawy
https://orcid.org/0000-0002-9467-0544
Urology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Tamer Abouelgreed
https://orcid.org/0000-0003-2640-3425
Urology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Ismail Ahmed
https://orcid.org/0000-0001-9636-3946
Anesthesia Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Abdalla Abdalla
https://orcid.org/0009-0001-6647-4335
Anesthesia Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Hany Ramadan
https://orcid.org/0009-0009-8450-2705
Anesthesia Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Mohamed Aboelsuod
https://orcid.org/0000-0001-5277-4153
Anesthesia Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Khaled Shrief
https://orcid.org/0009-0008-5660-2074
Anesthesia Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Ayman Mohamed
https://orcid.org/0009-0009-5264-6317
Anesthesia Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Wael Ibrahim
Anesthesia Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Saeed Abdelhameed
https://orcid.org/0000-0002-9103-6476
Anesthesia Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Mohammad Alghamdi
https://orcid.org/0009-0006-3482-769X
Urology Department, King Fahd Armed Forces Hospital, Jeddah, Saudi Arabia.
Mohammed Saleh Alzahrani
https://orcid.org/0009-0002-3627-126X
Urology department, King Fahd Armed Forces Hospital, Jeddah, Saudi Arabia, Saudi Arabia.
Hamada Youssof
https://orcid.org/0009-0005-9114-0838
Urology Department, Faculty of Medicine, Fayoum University, Egypt.

Objectives: To compare the efficacy of intrathecal fentanyl and dorsal penile nerve block for postoperative pain management in patients undergoing inflatable penile prosthesis (IPP).
Patients and methods: A prospective single-center study included 80 patients amenable to IPP. Patients were divided equally into two groups. Group I included 40 patients who were managed with spinal anesthesia with intrathecal fentanyl before undergoing IPP. Group II comprised 40 patients who received spinal anesthesia with dorsal penile block before IPP. Study groups were compared regarding postoperative VAS (Visual Analog Scale) scores, total narcotics consumption, patient satisfaction levels, and perioperative complications.
Results: The study groups were comparable regarding baseline patients’ criteria. The operative time was comparable between the study groups, with group I and group II having respective median times of 64 minutes (interquartile range: 55-78) and 67 minutes (interquartile range: 56-81) (p = 0.65). Additionally, both groups demonstrated similar distributions in IPP implant cylinder and reservoir size (p = 0.9). Postoperative pain was higher in group I, with a statistically significant difference (p < 0.001). Eight patients in group I (20%) called the physician’s office asking for pain medication, compared to two patients in group II (5%) (p = 0.04). 85% of patients in group II were highly satisfied compared to 50 % in group I (p = 0.003). We reported a 5% complication rate in group I compared to 2.5% in group II (p = 0.6).
Conclusions: The present study found that the dorsal penile nerve block offers superior postoperative pain control and patient satisfaction compared to intrathecal fentanyl for patients undergoing inflatable penile prosthesis insertion.

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Adel Elatreisy, Urology Department, Faculty of Medicine, Al-Azhar University, Cairo

Urology Department, King Fahd Armed Forces Hospital, Jeddah, Saudi Arabia

How to Cite

Elatreisy, A., Ahmed, Y., Elgarhy, A., Hindawy, M., Abouelgreed, T., Ahmed, I., Abdalla, A., Ramadan, H., Aboelsuod, M., Shrief, K., Mohamed, A., Ibrahim, W., Abdelhameed, S., Alghamdi, M., Alzahrani, M. S., & Youssof, H. (2024). Comparative study between intrathecal fentanyl and dorsal penile nerve block for controlling postoperative pain after inflatable penile prosthesis implantation. Archivio Italiano Di Urologia E Andrologia. https://doi.org/10.4081/aiua.2024.12951
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