Ultrasound-guided trans-perineal pudendal nerve block for post-hemorrhoidectomy voiding complications: a prospective randomized double-blinded study.

BACKGROUND

Post-hemorrhoidectomy urinary symptoms are common, with an incidence reaching 50% in some studies. Pudendal nerve block was used to alleviate pain and urinary symptoms after perineal surgeries. This study explored the effect of trans-perineal pudendal nerve block on the patient experience after hemorrhoidectomy, regarding urinary symptoms and analgesic requirements.

METHODS

This study included 66 patients randomly allocated into two equal groups. In group P, ultrasound-guided pudendal nerve block was applied after induction of anesthesia and lithotomy position, while no block was applied in group C.

RESULTS

The incidence of postoperative dysuria was significantly lower in group P (14% in group P, 40% in group C, p 0.028). Also, the mean numerical rating scale score and the frequency of analgesia requirements on the first day after surgery were significantly lower in group P (1.7 ± 1 vs. 0.5 ± 0.8, p 0.00, 3.8 ± 0.31 vs. 2.7 ± 0.59, p 0.00 consecutively).

CONCLUSIONS

Ultrasound-guided trans-perineal pudendal nerve block resulted in a better patient experience after hemorrhoidectomy, regarding urinary symptoms and analgesic requirements, without any noted complications.