Dorsal Penile Nerve block in adults; any best technique with U/S?

[Ligament]

Is there an accepted best U/G guided technique for dorsal penile nerve block in adults?

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[lobelsteve]

I'm really glad I am not a patient of yours.

You must have the craziest f'in referral base.

 

[bedrock]

I'm really glad I am not a patient of yours.

You must have the craziest f'in referral base.

+1000

 

[Ligament]

LOL you guys this is really cool stuff in a very grateful population. I try to be open to treating all pain complaints.

On the other hand, last dorsal penile block i did resulted in the dude leaking seminal fluid for a few days...resolved.

 

[painstop]

Hopefully he didn't impregnate anyone while standing in line at the grocery store.

 

[drf]

Never done it but seems interesting!

I would find the two dorsal arteries and inject 1 cc lateral to each and in the same compartment.

What I have been doing is pudendals for penile pain. Then when I pRF I search for stim to the dorsal penis nerve rather than perineal or inferior rectal.

I'm gonna try this,

 

[Ligament]

Never done it but seems interesting!

I would find the two dorsal arteries and inject 1 cc lateral to each and in the same compartment.

What I have been doing is pudendals for penile pain. Then when I pRF I search for stim to the dorsal penis nerve rather than perineal or inferior rectal.

I'm gonna try this,

I start with pudendals as well. Great idea on stim for dorsal penis branch! Do you place the RF needle at the traditional location for pudenal block for this (between sacrotuberous and sacrospinous ligament, medial to pudendal artery), or do you look elsewhere.

I'm finding 85% of men with pudendal neuralgia have glans penis parasthesias as the major complaint.

in my population, and as I'm sure in your case, 100% of these men have seen at least 3 urologists + random neurologist, general surgeon,etc.

 

[drf]

I start with pudendals as well. Great idea on stim for dorsal penis branch! Do you place the RF needle at the traditional location for pudenal block for this (between sacrotuberous and sacrospinous ligament, medial to pudendal artery), or do you look elsewhere.

I'm finding 85% of men with pudendal neuralgia have glans penis parasthesias as the major complaint.

in my population, and as I'm sure in your case, 100% of these men have seen at least 3 urologists + random neurologist, general surgeon,etc.

I use either fluoro is US. Fluoro I touch the spine, use that as a deepest depth gauge, then stim medial to lateral. Sometimes I get the penile stim medial over bone, sometimes lateral of the spine floating in free tissue. But it's there somewhere!

US same thing except I use artery as landmark. The nerve can be split into terminal branches already so I go for what looks like nerve then scan medial to lateral between the ligaments if I was wrong.

 

[Davidoshie2003]

I have been experiencing pain in my urethera and glans for over 1-1/2 years now. I was diagonosed with Pudendal Neuralgia. So far I have had 3 PN blocks at the alcocks cannal. Has anyone had good results with dorsal nerve injections to relieve uretheral pain and glans pain?