Open Access

ARTICLE

Peri-prostatic nerve block using Clarius EC7 HD₃ handheld ultrasound guidance

Aalya Hamouda¹, Ahmed Ibrahim², Nicholas Corsi³, Dean S. Elterman⁴, Bilal Chughtai⁵, Naeem Bhojani², Kevin C. Zorn²

1 Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
2 Division of Urology, University of Montreal Hospital Center, Montreal, Quebec, Canada
3 Wayne State University School of Medicine, Detroit, Michigan, USA
4 Division of Urology, University Health Network, University of Toronto, Toronto, Ontario, Canada
5 Department of Urology, Weill Cornell Medical College, New York Presbyterian, New York, New York, USA
Address correspondence to Dr. Kevin Zorn, University of Montreal Hospital Center, 1051 Sanguinet St, Montreal, QC H2X 3E4 Canada

Canadian Journal of Urology 2023, 30(6), 11741-11746.

Abstract

Transrectal ultrasound (TRUS) is a common modality used during urological procedures that require real-time visualization of the prostate, such as prostate biopsy and peri-prostatic nerve blocks (PNB) for surgical procedures. Current practice for TRUS-guided PNB requires use of costly, fixed, and non-portable ultrasound machinery that can often limit workflow. The Clarius endocavity EC7 probe, a digital, handheld and pocket-sized endocavity ultrasound (US) device, is an alternative, portable technology which was recently shown to accurately visualize and measure prostate dimensions and volume. Moreover, in recent years, there has been a renaissance of office-based treatments for minimally invasive surgical therapies (MIST) for the treatment of benign prostate hyperplasia (BPH). More specifically, the Rezūm procedure has been demonstrated to offer men a short, outpatient therapy with excellent 5-year outcomes in durability and preservation of antegrade ejaculation. While other anesthetic techniques have been described for Rez ūm, including inhaled methoxyflurane (Penthrox), nitrous oxide, IV sedation and general anesthesia (which often mandate the presence of an anesthesiology team), US-guided local blocks offer the urologist an independent method for pain management. While most urologists may not have direct access to expensive, cart-based ultrasound systems, point of care ultrasound (POCUS) technology, such as Clarius (Vancouver, BC, Canada) and Butterfly (Butterfly Network, Inc, Guilford, CT, USA), can provide high-resolution imaging in combination with smart phone technology. Herein, we sought to describe the technique for using Clarius EC7 for TRUS-guided PNB and its use in urological application with the Rezūm BPH procedure.

---

Keywords

---