%0 Journal Article
%T Subarachnoid versus General Anesthesia in Penile Prosthetic Implantation: Outcomes Analyses
%A Gerard D. Henry
%A Antonino Sacc¨¤
%A Elizabeth Eisenhart
%A Mario A. Cleves
%A Andrew C. Kramer
%J Advances in Urology
%D 2012
%I Hindawi Publishing Corporation
%R 10.1155/2012/696752
%X The leading patient complaint during the perioperative period for penile prosthesis implantation is postoperative pain, while emesis and urticaria also affect the procedure¡¯s perceived success. In analyzing surgical outcomes, assessment of the anesthetic for postoperative pain and side effects should be included. This paper retrospectively reviews 90 consecutive, primary inflatable penile prosthetic operations performed by a single surgeon at one private medical center. Fifty-seven patients were included in final analysis. Patients who had more than one procedure that day or who used chronic pain medication were excluded. The type and amount of each drug used for each respective side effect (within the first 24 hours after procedure) were compared to determine relative benefit. Twenty patients received general anesthesia (denoted herein as ¡°GA¡±) and 37 received spinal (or also known as subarachnoid) anesthesia (denoted herein as ¡°SA¡±). Patients receiving GA had significantly greater ( ) occurrence and amount of intravenous pain treatment than those receiving SA. Patients with SA required less intravenous pain medication and less treatment for nausea/emesis. 1. Introduction Penile prosthetic surgery has undergone significant changes since its introduction in the 1970¡¯s and it is now considered a safe and effective method of treating end organ failure impotence. As established by Pearman, an early leader in research in the field of surgical erectile dysfunction, impotence is defined as the inability to gain or maintain an erection sufficient to sustain satisfactory intercourse due to pathology or deformation of the penis [1]. The history of modern surgical treatment for erectile dysfunction began with the development of the inflatable penile prosthesis by Scott in the 1970s [1]. The popularity of inflatable penile prosthetics has increased since, and as the early designs yielded high failure rates, multiple revisions to the design and material have taken place. Current penile prosthetic implantation procedures prove to be both reliable and durable, with approximately 18,000 devices implanted annually worldwide [2]. With increased social awareness regarding erectile dysfunction, it appears there will be significant increases in penile prosthetic implantations in the future. In the past, postoperative complications of penile prosthetic surgery included, but were not limited to, infection, mechanical failure, device migration, sizing issues, and patient dissatisfaction. As penile prosthesis surgery remains elective, patient satisfaction is of paramount
%U http://www.hindawi.com/journals/au/2012/696752/