Vasovagal Syncope in Penoscrotal Inflatable Penile Prosthesis Implantation Following Spinal Anesthesia

Spinal anesthesia (SA) is increasingly recognized as a preferred alternative to general anesthesia (GA). Nonetheless, several factors must be carefully considered to ensure safe and practical application. Vasovagal syncope (VVS) or vasovagal reaction, characterized by a sudden decrease in heart rate (HR) and/or blood pressure (BP), is common during pain management procedures and SA administration in patients undergoing surgery. We report the case of a 57-year-old male who underwent SA during penoscrotal inflatable penile prosthesis (IPP) implantation. During the corporotomy closure, the patient developed a brief episode of sudden severe bradycardia and low BP, which was attributed to VVS. Penile prosthesis implantation (PPI) is commonly performed with SA. Both urologists and anesthesiologists strongly recommend identifying important risk factors, such as VVS, before SA to facilitate monitoring and rapid response to VVS during the procedure.