The obturator nerve block. Preventing damage of the bladder wall during transurethral surgery

During transurethral electroresection in the posterolateral bladder neck, trigone and posterior urethra, unintentional contractions of the thigh-adductor muscles may occur due to irritation of the obturator nerve. The sudden displacement of the bladder wall against the cutting loop may cause a perforation of the bladder. The authors describe the topographic relation of the bladder wall to the passage of the obturator nerve in the minor pelvis. The technique of obturator nerve block by local anaesthesia is described and its efficacy is demonstrated in 21 patients.