Local Anesthesia Irrigation Technique Reduces Post-Operative Pain Following Vasectomy Reversal
Philip Werthman, Mehran Movassaghi, Dean Berkis, Los Angeles, CA Presented at the American Urological Association Western Section Meeting 2010
Dr. Werthman has edited a textbook on male infertility published by W.B. Saunders, the leading medical publisher, and was the male fertility consultant to the popular book, Staying Fertile Longer.
Dr. Werthman and Dr. Rothman have also given a myriad of lectures over the years at international and national fertility society and urology meetings as well as to local and regional physician and patient groups.
Spermatic cord blocks delivered via needles have increased risks of hematoma or accidental injury to the vas. We evaluated a novel needleless approach in terms of post-operative pain and time spent in recovery in a retrospective manner. Our goal was show improved pain control using this novel method.
31 vasectomy reversal patient charts were evaluated in terms of post-operative pain scores, intravenous pain management and time to discharge. Group 1 (n=18) received local anesthetic using our needleless approach while group 2 (n=13) received no local anesthesia.
All Group 1 patients had a starting and ending post-operative pain score of zero and none required any pain medication while in the recovery room. Group 2 patients had an average starting and ending pain scores of 4.8 (range 0-8) and required an average of 25 mcgs of fentanyl (range 0-100 mcgs). Group 1 patients had a significant (p=0.0023) reduction in post-operative pain. The average time spent in recovery was 75 minutes for Group 1 and 80 minutes for Group 2.
Local anesthetic instillation with marcaine prior to closing the vasectomy reversal incision allows patients to awaken pain-free, alleviates post-operative pain and the need for narcotics in the recovery room. Patients receiving local anesthesia had a slightly shorter recovery room stay than matched controls.
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