Editorial Commentary on “Novel Multimodal Analgesia Protocol Significantly Decreases Opioid Requirements in Inflatable Penile Prosthesis Patients”

Abstract

The decision to proceed with a surgical resolution for severe erectile dysfunction has a significant impact on both short- and long-term quality of life. Placement of an inflatable penile prosthesis is safe and results in a high degree of patient satisfaction. Given the nature of the procedure, it is associated with pain and discomfort of varying degrees. Traditionally, opioid–based (OB) analgesia has been used to treat postoperative pain but recent media attention has placed the current opioid epidemic in the spotlight—prompting many to rethink this strategy. The authors of the current article1 should be commended for their timely attempts to elucidate a treatment algorithm focusing on a multimodal analgesic (MMA) protocol involving a combination of intraoperative pudendal and dorsal penile nerve blocks in conjunction with pre- and postoperative acetaminophen, meloxicam, and gabapentin. In brief, the article is a retrospective analysis of a database containing patients treated with 3-piece inflatable penile prosthesis implantation.1 Patient–reported postoperative pain scores as well as surrogates for opioid usage are assessed. While the data are enticing, a few issues warrant cautiousness prior to the adoption of such a protocol.