Some doctors do use a 'peri-prostatic' (local) block for PVP. (One
poster a little while ago entertainingly turned this into a
'peri-prosthetic' block, which would presumably only apply for people
who had suffered from severe erectile dysfunction!)

My urologist wasn't prepared to do local only (I did ask), mainly
because he hadn't used it up to that point, I think. I actually had an
epidural rather than a spinal, because he regards the risks as lower.
I didn't like it; though there was no pain, I could still move my
legs, and I definitely felt some trembling in them as a result of
strain from having them up in stirrups, by the end of the operation. I
also began to get some pain in my lower belly, I suspect from strain
on muscles which weren't anesthetised.

With the previous TUIP I had a spinal; with that there is absolutely
no feeling or movement during the procedure and for two or three hours
afterwards, and the lack of feeling went roughly up to my navel. As a
result, I found it more comfortable. (However, the TUIP took about
half an hour, and the PVP quite a lot longer, so I may not be
comparing like with like, I suppose.)

Both epidural and spinal allow you to watch the procedure if you want
to, providing the screen setup in the theatre allows it. I did see my
PVP 'live', though not the TUIP.

Richard Slessor