Prostate anesthetic infiltration (Block)


Prostate anesthetic infiltration (Block)

Approximate time20 min

With the emergence of minimally invasive techniques for the treatment of benign prostatic hyperplasia and the need to reduce health care costs, a simple, local and effective anesthetic injection of the prostate can be used to perform more procedures in a minor surgery room.  According to studies of neuroanatomy of the prostate, the perineal approach with ultrasound, seems to be the best way to anesthetise the prostate; the prostatic block is therefore effective for the control of pain.

Who are the candidates for a perineal prostatic block?

How does a perineal prostatic block take place?

The patient will be lying on his back, with his legs elevated in stirrups to expose the perineal area. Dr. Marois will introduce an ultrasound probe in the endorectal cavity, to visualize where he will perform the infiltration. The superficial perineal area will first be disinfected with Proviodine so that Dr. Marois can proceed with the aesthesia of the perineal region, with minimal risk of infection. The cutaneous layer of the perineal skin will be infiltrated by a local anesthetic in a rectangular manner and with a triangular extension, just above the anus. A large spinal needle will finally be introduced thru that anesthetised area, in order to reach the deeper peri-prostatic tissues with another anesthetic mixture.

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Preparation before a perineal prostatic block?

  • A single dose of antibiotics beforehand is necessary, to reduce the risk of skin infection.
  • Anxiolytic medication may be suggested for anxious or rather nervous patients. In this case, the patient must be accompanied.
  • It is important for the patient to inform Dr Marois or the nurses of the medication he is taking, especially Aspirin or Anticoagulant types. These drugs reduce the quality of blood clotting and increase the risk of bleeding.
  • Since the examination is done under local aesthesia, the patient does not need to be fasting.
  • To be more comfortable, it is encouraged to urinate before the procedure.

Recommendations after a perineal prostatic block

  • Dr. Marois recommends treating the affected area for the first 48 hours, with ice (bag of gel or peas, wrapped in a wet towel) at 15-minutes intervals. This helps to decrease the post-operative oedema and the discomfort more quickly.
  •  Dr Marois recommends taking a Tylenol 500 mg regularly, every 4 hours, during the first day and to avoid Advil brand medications or other anti-inflammatory drugs that may increase the risk of bleeding.  A shower is allowed after 24 hours.
  • No physical, sexual or sports effort for 48 hours. Thereafter, you can resume your physical and sexual activities, according to your tolerance.

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