A double-blind, randomized, controlled trial of topical glyceryl trinitrate for transrectal ultrasound guided prostate biopsy.
OBJECTIVE
We evaluated the efficacy and tolerance of topical 0.2% glyceryl trinitrate (GTN) paste vs placebo to decrease pain associated with transrectal ultrasound guided prostate biopsy.


METHODS
Between October 2003 and April 2004, 134 consecutive patients referred for a first prostate biopsy were randomized to receive topical 0.2% GTN paste or placebo 30 minutes prior to biopsy. Participants completed a 10 point visual analog pain score following the procedure.


RESULTS
Mean patient age was 68.5 years in the GTN group and 68.8 in the placebo group. There was a significant decrease in mean pain score in the GTN group compared with placebo (3.7 vs 4.8, p <0.05). Six patients (10%) in the GTN group complained of headache.


CONCLUSIONS
Topical GTN paste is an effective and well tolerated method of decreasing pain associated with transrectal ultrasound guided prostate biopsy. It is safe and easy to use, and it should be offered to patients undergoing this procedure.
Rochester
Mark A
MA
Department of Urology, Churchill Hospital, Oxford, United Kingdom. rochester@doctor.org.uk
LE Monnier
Karena
K
Brewster
Simon F
SF
D000287:Administration, Topical; D000368:Aged; D001706:Biopsy / Q000009:adverse effects* / Q000379:methods; D004311:Double-Blind Method; D006801:Humans; D008297:Male; D005996:Nitroglycerin / Q000008:administration & dosage*; D010146:Pain / Q000517:prevention & control*; D011467:Prostate / Q000000981:diagnostic imaging* / Q000473:pathology*; D012007:Rectum; D014463:Ultrasonography
D005996:Nitroglycerin