Penile Nerve Block

Last updated 03.11.12

Definition

-  Peripheral nerve block of the penis

 

Features

-  Penis supplied by pudendal nerve (S2-S4)

-  Divides into left & right dorsal nerve of penis

-  Topicl Emla cream may be used as an alternative

 

Indications

-  Priapism for aspiration

-  Reduction of Phimosi or Paraphimosis

-  Circumcision

-  Penile laceration/trauma/zipper

 

Equipment

-  Lighting

-  Strile gloves 

-  LA: Lidocaine 2%

-  Do not use Adrenaline

-  5ml syrine

-  Drawing up & 27G needles

-  Chlorhexadine with Cetrimide or Betadine prep

-  Gauze

 

Procedure

-  Consider PO/IV analgesia

-  Patient supine

-  Traction on penile shaft with left hand

-  Palpate dorsal base of penis for notch between penis & pubic ramus

-  Inject 2ml of LA around 0.5cm from midline 0.5 - 1cm deep towards base of penis

-  Aspirate prior to injection

-  Perform at the 2 oclock & 10 oclock positions

-  Avoid dorsal vein of penis & corpus cavernosu

-  Loss of resistance indicates needle has entered Bucks fascia

Anatomy

 

Complications

-  Haematoma

 

 

 

References

 

eMedicine: Penile Nerve Block