Penile Block

Question 1

What nerves supply sensation to the penis?

Answer 1

Primary innervation is derived from the pudendal nerve which
branches into the dorsal nerves of the penis.
Barash PG, Cullen BF, Stoelting RK, Cahalan MK, Stock MC,
Ortega R. Clinical Anesthesia. 7th ed. Philadelphia, PA:
Lippincott Williams and Wilkins; 2013: 977.

Question 2

Why would the dorsal nerves need to be blocked

separately following a penile block?

Answer 2

Additional blockade of the dorsal nerves can provide profound
anesthesia for more complicated procedures.
Barash PG, Cullen BF, Stoelting RK, Cahalan MK, Stock MC,
Ortega R. Clinical Anesthesia. 7th ed. Philadelphia, PA:
Lippincott Williams and Wilkins; 2013: 977.

Question 3

How is a penile block performed?

Answer 3

A fan-shaped field block using 10-15 mL of local anesthetic
(without epinephrine) is injected on the dorsal aspect of the
base of the penis and 2-4 cm lateral on both sides of the penis
just below and medial to the pubic spine.
Barash PG, Cullen BF, Stoelting RK, Cahalan MK, Stock MC,
Ortega R. Clinical Anesthesia. 7th ed. Philadelphia, PA:
Lippincott Williams and Wilkins; 2013: 977.

Question 4

What are the potential complications of a penile

block?

Answer 4

The injection of large volumes of local anesthetic or injection of
a local anesthetic that contains vasoconstrictors such as
epinephrine can jeopardize blood flow to the penis.
Barash PG, Cullen BF, Stoelting RK, Cahalan MK, Stock MC,
Ortega R. Clinical Anesthesia. 7th ed. Philadelphia, PA:
Lippincott Williams and Wilkins; 2013: 977.