title: Modified perianal/pericapsular anesthesia for transrectal biopsy of prostate in patients with anal rectal problems.
abstract: OBJECTIVE
  To modify our technique of perianal anesthesia and use it in patients with painful conditions of the rectum and/or anus.
  
  
  METHODS
  A total of 31 consecutive patients with anal-rectal problems underwent prostate needle biopsy. Of these, 17 were referred to our hospital after vain attempts to insert a transrectal ultrasound probe. Patients received a perianal-pericapsular injection of 1% lidocaine. Pain perception was separately assessed for probe insertion and biopsies using a visual pain analog score.
  
  
  RESULTS
  Only in 1 patient were we unable to insert the transrectal ultrasound probe. The mean patient age was 65.28 +/- 5.35 years. We performed a mean of 12.25 biopsies per case. At probe insertion, the mean pain score was 2.2 +/- 0.83. During the biopsy punctures, the mean pain level was 2.53 +/- 1.054. We did not find any increase in the complication rate related to the anesthesia method.
  
  
  CONCLUSIONS
  Modified perianal anesthesia can be used for transrectal ultrasound-guided biopsy of the prostate in patients with anal-rectal problems, because it provides significant pain relief.
authors.affiliation: Department of Urology, Barzilai Medical Center, Ashkelon, Israel. cambell@netvision.net.il
authors.forename: Sergey
authors.initials: S
authors.lastname: Kravchick
authors.forename: Boris
authors.initials: B
authors.lastname: Yoffe
authors.forename: Shmuel
authors.initials: S
authors.lastname: Cytron
mesh_terms: D000368:Aged; D001003:Anal Canal; D000772:Anesthesia, Local / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D001707:Biopsy, Needle / Q000379:methods; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D011467:Prostate / Q000473:pathology*; D012002:Rectal Diseases; D012007:Rectum
chemical_list: D000779:Anesthetics, Local; D008012:Lidocaine