(118) SURGICAL OUTCOMES OF BENIGN SCROTAL SURGERY PERFORMED UNDER LOCAL ANESTHESIA

Abstract Introduction General and spinal anesthesia are often used to perform benign scrotal surgery. However, these methods yield substantial healthcare costs, potential side effects, and given the benign nature of the conditions, patients often face considerable wait times to receive surgical care. The use of local anesthesia (LA) only has previously been shown to demonstrate satisfactory patient tolerability for scrotal surgery. However, evidence is limited, and further research is required to evaluate its safety. Objective We sought to evaluate patient intolerability, intra-operative complications and 4–6-week procedure-related adverse events. Methods We conducted a retrospective study of patients undergoing the following procedures, 1) hydrocelectomy, 2) spermatocelectomy, and 3) epididymectomy, at a Canadian ambulatory surgical centre from October 2022 to June 2024. LA administration was performed through a spermatic cord block as well as along the median raphe for all procedures. Procedures performed for a large hydrocele or spermatocele where an early block was not possible, were subsequently performed after delivery of the testicle. Baseline characteristics, intra-operative events, and post-operative adverse events were collected. Results From October 2022 to June 2024, a total of 72 procedures were performed. Of these procedures, 39% (n = 28) were hydrocelectomies, 33% (n = 24) were spermatocelectomies, and 28% (n = 20) were epididymectomies. The mean patient age was 52.6 ± 14.3 years with a BMI of 31.2 ± 11.1. No procedures were aborted due to patient intolerability nor were there any reported intra-operative complications. At 4-6 weeks post-operative follow-up, no patients sought care from their family doctor with only 1.4% (n = 1) patients requiring an emergency department visit for a wound infection. No patients required hospital admission. Conclusions Our early findings demonstrate the safety and feasibility of performing surgical scrotal procedures in an outpatient setting under LA. Safely performing these procedures in an outpatient setting can reduce patient wait times for scrotal surgeries, boost tertiary care centre efficiency, and optimize the use of scarce resources such as operating rooms and inpatient facilities. Further longer-term follow-up is needed to evaluate recurrence rates. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Boston Scientific.