HOW I DO IT

• How I Do It: Penthrox in Urology

  Ferreira Roseanne, Zorn C. Kevin, Bhojani Naeem, Chughtai Bilal, Elterman S. Dean Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada

  ---

  Penthrox is a portable handheld inhaler that delivers a low dose of methoxyflurane - an anesthetic with analgesic effects, rapid onset of action, and a favorable side-effect profile. It has been widely used for acute pain management in Australia for the past 40 years. Currently, it is approved for use in over 55 countries, including Canada. Prospective randomized studies highlight Penthrox analgesic effectiveness and safety profile for emergency, prehospital and outpatient settings. In addition, the use of multimodal analgesia, specifically Penthrox, can play an important role in the analgesic management of urological procedures, such as prostatic biopsies and office-based minimally invasive surgical therapies. Herein readers will familiarize themselves with Penthrox, significant studies, and technique used for outpatient urological procedures.

  Keywords: urology, analgesia, Penthrox, methoxyflurane, MIST,

  Feb 2023 (Vol. 30, Issue 1 , Page 11448)
  PDF (102.7KB)Free
• How I do it: Aquablation in very large prostates (> 150 mL)

  Helfand T. Brian, Kasraeian Ali, Sterious Steve, Glaser P. Alexander, Talaty Pooja, Alcantara Miguel, Alcantara Mola Kaitlyn, Higgins Andrew, Ghiraldi Eric, Elterman S. Dean Department of Surgery, NorthShore University Health System, Evanston, Illinois, USA

  ---

  Aquablation has been well-studied in prostates sizes up to 150 mL. Recently, American Urological Association guidelines distinguish surgical interventions for men with large prostates (80 mL-150 mL) and now very large prostates (> 150 mL). Readers will gain an understanding of how to use Aquablation in the very large prostate size category.

  Keywords: robotics, LUTS, BPH, aquablation, prostate surgery, urology,

  Apr 2022 (Vol. 29, Issue 2 , Page 11111)
  PDF (1.97MB)Free
• How I Do It: The pudendal nerve block for pediatric ambulatory urologic surgery

  Okoro Chinonyerem, Cannon Shannon, Low Daniel, Lendvay S. Thomas, MD Department of Urology, University of Washington Medical Center, Seattle, WA

  ---

  

  Regional analgesia is an important adjunct for perioperative pain management in the setting of pediatric penile surgeries. Caudal epidural analgesia (CEA) is the most common analgesic technique performed, but it has limitations and associated morbidity. The pudendal nerve block (PNB) is an effective alternative to CEA with a lower risk profile; in prior examination of the approach, PNB has been demonstrated to have similar postoperative pain control outcomes. We describe our technique and highlight observations made as we have transitioned from CEA to PNB for many patients.

  Keywords: pudendal nerve block, regional anesthesia, pediatric urology, pain management,

  Apr 2021 (Vol. 28, Issue 2 , Page 10648)
  PDF (217.7KB)Free