[Local anesthesia significantly improves the tolerance of prostate biopsy].
Transrectal biopsy is one of the most frequent procedures in urological practice. Generally, transrectal biopsies have been practiced without anesthesia, because of a supposed good tolerance. Nevertheless, it is not infrequent to find patients with a high level of pain and adverse effects attributable to such procedure.


OBJECTIVE
In the present article the effect of transrectal local anesthesia in order to significantly diminish the perception of pain by the patient is evaluated.


METHODS
A total of 131 consecutive patients undergoing transrectal prostate biopsy are included in the study. After randomization, 76 patients were biopsiated with anesthesia and 55 represent the control group. Cases and control groups do not differ in age or prostate volume. Anesthesia consisted on a periprostatic nerve blockage with injection of 5 cc of 1% mepivacaine solution in the angle between prostate and seminal vesicles bilaterally. A visual analogical scale for pain was used; it was given to the patient at the end of the procedure.


RESULTS
Mean pain value was 2.41 with a median of 2.0 in the group with anesthesia, and 4.02 with a median of 4 in the control group. A Student's t test comparing the means showed a statistically significant difference of 1.61 (p < 0.0001). Pain in the scale was 66% greater in the control group.


CONCLUSIONS
The use of anesthesia in the performance of transrectal biopsies significantly diminishes the perception of pain by patients. This effect, along with the tendency to increase the number of biopsies, will result in short time in a more generalized use of local anesthesia.
Feltes Ochoa
Javier Amalio
JA
Servicio de Urología, Hospital Universitario 12 de Octubre, Madrid, España. djafo73@hotmail.com
Passas Martínez
Juan
J
Felip Santamaría
Nerea
N
Romero Otero
Javier
J
Rodríguez Antolín
Alfredo
A
Leiva Galvis
Oscar
O
D000368:Aged; D000772:Anesthesia, Local; D001707:Biopsy, Needle / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology* / Q000517:prevention & control*; D011471:Prostatic Neoplasms / Q000473:pathology*