A prospective randomized trial comparing lidocaine and lubricating gel on pain level in patients undergoing transrectal ultrasound prostate biopsy.
OBJECTIVE
To compare patient reported pain during TRUS guided biopsies using intrarectal lidocaine gel versus lubricating gel.


METHODS
From May 2000 to May 2001, 360 men undergoing transrectal prostate biopsy were enrolled in this study. Patients were randomized into two groups. In group 1, 180 patients received 10 cc of 2% intrarectal lidocaine gel (Xylocaine 2% jelly, Astra Pharma Inc.) 5 to 10 minutes before the procedure and in group 2, 180 patients received 10 cc of lubricating gel. No other sedation or analgesia was given. Pain level immediately after the last biopsy was assessed using a 10-point linear visual analog pain scale.


RESULTS
The median pain score during transrectal prostate biopsy was 2 (range 0 to 8) and 3 (range 1 to 10) in groups 1 and 2, respectively (p = 0.0001). Only minor complications occurred and complication rates were not significantly different between the groups.


CONCLUSIONS
Rectal administration of lidocaine gel is safe, simple and effective for reducing the pain level associated with transrectal prostate biopsy.
Saad
Fred
F
Division of Urology, Centre Hospitalier de l'Université de Montréal, Université de Montréal, Montréal, Québec, Canada.
Sabbagh
Robert
R
McCormack
Michael
M
Péloquin
François
F
D000368:Aged; D000779:Anesthetics, Local / Q000627:therapeutic use*; D001706:Biopsy / Q000379:methods; D005782:Gels / Q000627:therapeutic use; D006801:Humans; D008012:Lidocaine / Q000627:therapeutic use*; D008153:Lubrication; D008297:Male; D010147:Pain Measurement; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging; D014463:Ultrasonography; D036761:Ultrasound, High-Intensity Focused, Transrectal
D000779:Anesthetics, Local; D005782:Gels; D008012:Lidocaine