[Penile prosthesis. Implantation under local anesthesia]

We report our motivation, technique, results and the current status of penile prosthesis implantation under local anesthesia at our institution. The lack of anesthetists to cope with the surgical demands and the conflicting views on the priority assigned to the different pathologies prompted us to seek an alternative approach.

Anesthetic blockade with mepivacaine (2%) for the pudendal nerve branches (dorsal and perineal, in some cases; cavernous, in the first one) responsible for penile innervation, and anesthetic blockade of the genitofemoral and ilioinguinal nerves that innervate the scrotum and its contents. Of the five patients, 80% had excellent and 20% had good tolerance of the procedure. The definition of the foregoing categories are discussed herein. Currently, we have no waiting list or conflicts relative to treatment priorities. We reserve the technique for patients with anesthetic contraindications, as case number five.