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51st Annual Regional Anesthesiology and Acute Pain Medicine Meeting
April 16 - 18, 2026 | Phoenix, Arizona
2317406
The Novel Application of Pudendal and Ilioinguinal Nerve Blocks in Pediatric Vaginoplasty: A Case Report
Poster Presenter
Authors
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Part of Topic
Scientific Abstracts > Regional Anesthesia
INTRODUCTION
Congenital adrenal hyperplasia (CAH) results invarying virilization of genetically female (XX)infants, often necessitating reconstructive surgeryto restore functional female anatomy and near-normal appearing external genitalia.1
Caudal anesthesia (CA) has been used historicallyfor post-operative analgesia and provides fulldermatomal analgesia, but its use is limited by:2,4-5
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Shorter duration (single injection)
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Motor weakness
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Urinary retention
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Neuraxial contraindications
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Hemodynamic considerations
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Institutional / surgeon preference
Research supports pudendal nerve block (PNB) assuperior to CA for hypospadias repair4-5
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Provides incomplete dermatomal coveragefor more extensive procedures
DISCUSSION
Surgeon preference, a postoperative immobilizationdressing, and known side effects limit use of singleinjection & continuous CA.
Scant literature exists for peripheral nerve blocks asalternatives to neuraxial for reconstructivevaginoplasties in adults and pediatrics.
After a combined bilateral US-guided pudendaland ilioinguinal nerve block technique, our patientshowed remarkable intraoperative hemodynamicstability, good postop analgesia, and an opioid-freerecovery.
Consider future prospective trials and non-inferioritystudies with combined pudendal-ilioinguinaltechnique in both adults and pediatrics with varyingstages of disease.