title: Pain during transrectal ultrasonography guided prostate biopsy: a randomized prospective trial comparing periprostatic infiltration with lidocaine with the intrarectal instillation of lidocaine-prilocain cream.
abstract: Prostate biopsy is usually performed without anesthesia. We evaluated the patient's perception of pain/discomfort experienced during the procedure in terms of the type of anesthesia used: periprostatic infiltration with 2% lidocaine, or intrarectal instillation of lidocaine-prilocain cream. A total of 198 patients were divided into three groups: group 1 (control group, n=40) received sonographic gel intrarectally prior to biopsy, group 2 (n=75) were given intrarectal instillation of lidocaine-prilocain cream, and group 3 (n=80) received periprostatic anesthesia by injecting 10 ml of 2% lidocaine. Pain after each biopsy was assessed using an 11-point linear visual analog pain scale. The mean pain scores were 5.1 in group 1, 4.8 in group 2, and 2.5 in group 3, resulting in a significant difference between group 3 and both groups 1 and 2, but not between groups 1 and 2. The incidence of biopsy-related adverse events did not differ among groups. Transrectal ultrasonographic guided periprostatic anesthesia is superior to intarectal instillation of lidocaine-prilocain cream.
authors.affiliation: 1st Department of Urology, Athens University Medical School, Laiko General Hospital, 17 Agiou Thoma Street, 115 27 Athens, Greece.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Adamakis
authors.forename: Dionisios
authors.initials: D
authors.lastname: Mitropoulos
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Haritopoulos
authors.forename: Christos
authors.initials: C
authors.lastname: Alamanis
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Stravodimos
authors.forename: Aris
authors.initials: A
authors.lastname: Giannopoulos
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000772:Anesthesia, Local; D019162:Anesthetics, Combined / Q000008:administration & dosage*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D001706:Biopsy / Q000009:adverse effects / Q000379:methods; D004304:Dosage Forms; D006801:Humans; D007322:Instillation, Drug; D008012:Lidocaine / Q000008:administration & dosage*; D000077442:Lidocaine, Prilocaine Drug Combination; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000517:prevention & control*; D011318:Prilocaine / Q000008:administration & dosage*; D011467:Prostate / Q000000981:diagnostic imaging* / Q000473:pathology*; D014463:Ultrasonography
chemical_list: D019162:Anesthetics, Combined; D000779:Anesthetics, Local; D004304:Dosage Forms; D000077442:Lidocaine, Prilocaine Drug Combination; D011318:Prilocaine; D008012:Lidocaine