Purpose: To evaluate the effectiveness of transperineal urethrosphincteric block (TUSB) in providing analgesia during visual internal urethrotomy for patients with anterior urethral strictures.
Patients and methods: A total of 26 consecutive patients scheduled for elective visual internal urethrotomy for symptomatic urethral stricture were considered for this prospective study. Twenty-four patients agreed to participate in the study. Their demographics and medical conditions were recorded. Twenty-five percent of the patients had comorbid conditions that would have put them at high risk for general anesthesia. All patients had TUSB as the primary method of analgesia, using 1% lidocaine. Postoperatively, patients were asked to score the severity of the pain experienced during TUSB and during the transurethral surgery on a scale from 0 to 10. Postoperative adverse effects and the need for sedation or additional analgesia were recorded. All patients rated their overall satisfaction with the analgesia.
Results: Patient mean age was 43.5 years (range 26-71 years). The mean pain score during instillation of the transperineal block was 1.9 (range 0-3), and for visual internal urethrotomy was 1 (range 0-5). No sedation, narcotics, or additional analgesia were required and no postoperative adverse effects were encountered. Ninety-two percent of the patients were very satisfied with the method of analgesia.
Conclusion: TUSB is a safe and effective method of local analgesia for visual internal urethrotomy in patients with anterior urethral strictures, and is particularly suitable for those at high risk of general anesthesia.