Intraurethral prostate injections with mepivacaine epinephrine: effects on patient comfort, treatment time and energy consumption during high-energy transurethral microwave thermotherapy.
OBJECTIVE
To investigate the effects of intraprostatic mepivacaine epinephrine injections administered by the Schelin catheter during high-energy transurethral microwave thermotherapy (TUMT) using the CoreTherm Prostalund Feedback Treatment (PLFT) system.


METHODS
The study included 85 men with lower urinary tract symptoms due to benign prostatic enlargement. One group had intraprostatic injections with mepivacaine epinephrine by the new Schelin catheter, while patients in the other group were treated without intraprostatic injections. All men were treated by TUMT using the PLFT system. Before treatment, transrectal ultrasound (TRUS) volume was measured. During the procedure, treatment time, energy consumption, cell-kill parameter and maximal prostate temperature were recorded. Patients who needed perioperative intravenous analgesics and the rate of perioperative and postoperative complications were registered.


RESULTS
The patients who had intraprostatic and periprostatic injections with mepivacaine epinephrine had shorter effective treatment time and reduced energy consumption. There was also a difference between the two groups in that 70% of patients without intraprostatic injections and only 11% of injected patients needed intravenous analgesics. No differences were found in TRUS volume, estimated cell-kill, maximal prostate temperature or complication rates.


CONCLUSIONS
Intraprostatic injections with mepivacaine epinephrine distributed by the Schelin catheter reduce the number of patients needing intravenous analgesics during PLFT, as well as the treatment time and energy consumption during treatment. Besides improved patient comfort, intraprostatic and periprostatic injections condense the treatment time without side-effects, making PLFT less cumbersome for most patients.
Knutson
Tomas
T
Department of Urology, Sahlgrenska University Hospital, Göteborg, Sweden.
Johansson
Annika
A
Damber
Jan-Erik
JE
Fall
Magnus
M
Vesely
Stepan
S
Peeker
Ralph
R
D000368:Aged; D000369:Aged, 80 and over; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007267:Injections; D008297:Male; D008619:Mepivacaine / Q000008:administration & dosage / Q000627:therapeutic use*; D008875:Middle Aged; D010146:Pain / Q000517:prevention & control*; D011470:Prostatic Hyperplasia / Q000150:complications / Q000601:surgery*; D013997:Time Factors; D020728:Transurethral Resection of Prostate / Q000009:adverse effects* / Q000379:methods; D016896:Treatment Outcome; D014570:Urologic Diseases / Q000209:etiology
D000779:Anesthetics, Local; D008619:Mepivacaine