Open Access

HOW I DO IT

Use of the Schelin Catheter for transurethral intraprostatic anesthesia prior to Rez ūm treatment

Aalya Hamouda¹, Ahmed Ibrahim², Nicholas Corsi³, Giampaolo Siena⁴,Dean S. Elterman⁵, Bilal Chughtai⁶, Naeem Bhojani², Francesco Sessa⁴, Anna Rivetti⁴, Silvia Secco⁷, Kevin C. Zorn^2,8

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 Department of Urology, University of Florence, Careggi, Florence, Italy
5 Division of Urology, University Health Network, University of Toronto, Toronto, Ontario, Canada
6 Department of Urology, Weill Cornell Medical College, New York Presbyterian, New York, New York, USA
7 Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
8 BPH Canada Prostate Center, Mont-Royal Surgical Center, Montreal, Quebec, Canada
Address correspondence to Dr. Kevin C. Zorn, BPH Canada Prostate Institute, 6900 Decarie Blvd, Suite M270, Montreal, QC H3X 2T8 Canada

Canadian Journal of Urology 2024, 31(1), 11802-11808.

Abstract

Minimally invasive surgery techniques (MIST) have become newly adopted in urological care. Given this, new analgesic techniques are important in optimizing patient outcomes and resource management. Rez ūm treatment (RT) for BPH has emerged as a new MIST with excellent patient outcomes, including improving quality of life (QoL) and International Prostate Symptom Scores (IPSSs), while also preserving sexual function. Currently, the standard analgesic approach for RT involves a peri prostatic nerve block (PNB) using a transrectal ultrasound (TRUS) or systemic sedation anesthesia. The TRUS approach is invasive, uncomfortable, and holds a risk of infection. Additionally, alternative methods such as, inhaled methoxyflurane (Penthrox), nitric oxide, general anesthesia, as well as intravenous (IV) sedation pose safety risks or mandate the presence of an anesthesiology team. Transurethral intraprostatic anesthesia (TUIA) using the Schelin Catheter (ProstaLund, Lund, Sweden) (SC) provides a new, non-invasive, and efficient technique for out-patient, office based Rez ūm procedures. Through local administration of an analgesic around the prostate base, the SC has been shown to reduce pain, procedure times, and bleeding during MISTs. Herein, we evaluated the analgesic efficacy of TUIA via the SC in a cohort of 10 patients undergoing in-patient RT for BPH.

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