Alex L. Finkle

Sexual potency in aging males. III. Technic of avoiding nerve injury in perineal prostatic operations.

Abstract The definition of sexual potency should include the desire for and successful completion of coitus. Psychologic and sociologic factors greatly affect potency; these alone can predispose to or precipitate sexual difficulties following prostatectomy. Anatomic relationships and probable mechnisms of surgical injury to parasympathetic fibers in the perineum are cited. Technics are described to avoid the participation of surgical trauma in such urinary and sexual dysfunction as may occur after perineal prostatectomy.

Prostatic cancer. V. Improvements in pudendal nerve block anesthesia for surgical perineal biopsy of the prostate.

Abstract Revisions of and additions to the technic of local anesthesia for perineal dissection and open biopsy of the prostate are presented. Refinements in positioning of the patient on the operating table are pictured. Topical anesthesia of the urethra and bladder, better analgesic control by use of intravenous demerol and nembutal, and inclusion of the inferior hemorrhoidal nerve in the perineal nerve block represent improvements cited in this report. Results in twenty-nine cases in which patients were anesthetized by these methods were tabulated. Twenty-one were satisfactory, five were fair and three were unsatisfactory. The safety, feasibility and usefulness of local anesthesia of the perineum for diagnostic evaluation of possible carcinoma of the prostate appear to justify this anesthetic approach.