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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
QUADRUPLE
Enrollment
258
Dorsal penile nerve block with 0.33% ropivacaine using 22-G needle in the sub-pubic space at the base of the penis
0.33% Ropivacaine administered around dorsal penile nerve using 22-G needle in the sub-pubic space at the base of the penis
1% Tetracaine gel instilled into urethra
West China Hospital of Sichuan University, Department of Anesthesiology
Chengdu, Sichuan, China
Visual Analog Scale (VAS) for Pain
A visual analog scale (VAS) ranging from 0 to 10 was used to assess the patients' pain during the procedure. 0 means no pain, 1 to 3 means mild pain, 4 to 7 means moderate pain, and 8 to 10 means severe pain. Patients were asked the VAS score to express the degree of pain at each time point.
Time frame: at cystoscopic inspection of external sphincter
Visual Analog Scale (VAS) for Pain
A visual analog scale (VAS) ranging from 0 to 10 was used to assess the patients' pain during the procedure. 0 means no pain, 1 to 3 means mild pain, 4 to 7 means moderate pain, and 8 to 10 means severe pain. Patients were asked the VAS score to express the degree of pain at each time point.
Time frame: before gel administration
Visual Analog Scale (VAS) for Pain
A visual analog scale (VAS) ranging from 0 to 10 was used to assess the patients' pain during the procedure. 0 means no pain, 1 to 3 means mild pain, 4 to 7 means moderate pain, and 8 to 10 means severe pain. Patients were asked the VAS score to express the degree of pain at each time point.
Time frame: at cystoscopic inspection of penile and bulbar urethra
Visual Analog Scale (VAS) for Pain
A visual analog scale (VAS) ranging from 0 to 10 was used to assess the patients' pain during the procedure. 0 means no pain, 1 to 3 means mild pain, 4 to 7 means moderate pain, and 8 to 10 means severe pain. Patients were asked the VAS score to express the degree of pain at each time point.
Time frame: at cystoscopic inspection of prostate and bladder
Visual Analog Scale (VAS) for Pain
A visual analog scale (VAS) ranging from 0 to 10 was used to assess the patients' pain during the procedure. 0 means no pain, 1 to 3 means mild pain, 4 to 7 means moderate pain, and 8 to 10 means severe pain. Patients were asked the VAS score to express the degree of pain at each time point.
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Time frame: after withdrawal of cystoscope
Heart Rate Before Gel Administration
Time frame: before gel administration
Heart Rate at Cystoscopic Inspection of Penile and Bulbar Urthra
Time frame: at cystoscopic inspection of penile and bulbar urethra
Heart Rate at Cystoscopic Inspection of External Sphincter
Time frame: at cystoscopic inspection of external sphincter
Heart Rate After Withdrawal of Cystoscope
Time frame: after withdrawal of cystoscope
Mean Arterial Pressure Before Gel Administration
Time frame: before gel administration
Mean Arterial Pressure at Cystoscopic Inspection of Penile and Bulbar Urthra
Time frame: at cystoscopic inspection of penile and bulbar urthra
Mean Arterial Pressure at Cystoscopic Inspection of External Sphincter
Time frame: at cystoscopic inspection of external sphincter
Mean Arterial Pressure After Withdrawal of Cystoscope
Time frame: after withdrawal of cystoscope
Oxygen Saturation by Pulse Before Gel Administration
Time frame: before gel administration
Oxygen Saturation by Pulse at Cystoscopic Inspection of Penile and Bulbar Urthra
Time frame: at cystoscopic inspection of penile and bulbar urthra
Oxygen Saturation by Pulse at Cystoscopic Inspection of External Sphincter
Time frame: at cystoscopic inspection of external sphincter
Oxygen Saturation by Pulse After Withdrawal of Cystoscope
Time frame: after withdrawal of cystoscope
Breath Rate Before Gel Administration
Time frame: before gel administration
Breath Rate at Cystoscopic Inspection of Penile and Bulbar Urthra
Time frame: at cystoscopic inspection of penile and bulbar Urthra
Breath Rate at Cystoscopic Inspection of External Sphincter
Time frame: at cystoscopic inspection of external sphincter
Breath Rate After Withdrawal of Cystoscope
Time frame: after withdrawal of cystoscope