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Effectiveness of local anaesthesia techniques in patients undergoing transrectal ultrasound‐guided prostate biopsy: A prospective randomized study
Author(s) -
SONG SEUNGHUN,
KIM JEONG KON,
SONG KANGHYON,
AHN HANJONG,
KIM CHOUNGSOO
Publication year - 2006
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/j.1442-2042.2006.01390.x
Subject(s) - medicine , lidocaine , visual analogue scale , neurovascular bundle , urinary retention , prostate biopsy , prostate , biopsy , local anesthesia , surgery , anesthesia , lower urinary tract symptoms , urology , bladder outlet obstruction , saline , radiology , cancer
Aim: This study was designed to compare the effectiveness of intrarectal lidocaine gel versus periprostatic lidocaine injection during transrectal ultrasound (TRUS)‐guided prostate biopsy. Methods: Ninety men undergoing transrectal prostate biopsy from July through December 2004 were randomized into three groups of 30 patients each. Before the biopsy, patients in Group 1 received 20 mL of 2% lidocaine gel intrarectally; patients in Group 2 received 5 mL (2.5 mL per side) of 2% lidocaine solution injected near the junction of the seminal vesicle with the base of the prostate (along the neurovascular bundles), and patients in Group 3 (control group) received 5 mL (2.5 mL per side) of normal saline injected along the neurovascular bundles. Pain level after the biopsy was assessed using a 10‐point linear visual analog scale (VAS). Results were statistically compared by the Wilcoxon Rank Sum test. Results: Patients in Group 2 had significantly lower VAS scores than those in Group 3 (3.6 ± 2.1 vs 5.8 ± 1.9, P < 0.0001), but those in Group 1 did not (5.5 ± 2.7 vs 5.8 ± 1.9, P = 0.67). Gross hematuria, rectal bleeding, and hemospermia occurred in 36 (40.0%), 6 (7%) and 5 (6%) patients. One patient had temporary vasovagal syncope. No patient reported febrile urinary tract infection or urinary retention. Conclusions: Periprostatic injection of local anaesthetic is a safe technique that significantly reduces pain during prostate biopsy, whereas intrarectal lidocaine injection did not reduce pain. This safe, simple technique should be applied in men undergoing TRUS‐guided prostate biopsy to limit patient discomfort.