Visual pain score during transrectal ultrasound-guided prostate biopsy using no anaesthesia or three different types of local anaesthetic application.
OBJECTIVE
To evaluate the pain score during transrectal ultrasound (TRUS)-guided prostate biopsy using three different anaesthetic applications and no anaesthesia.


METHODS
One-hundred men undergoing TRUS-guided prostate biopsy were prospectively enrolled in this study. Patients were randomized to four groups. Group 1 (n = 25) received no anaesthesia, group 2 (n = 25) was administered a perianal lidocaine injection, group 3 (n = 25) was administered a periprostatic lidocaine injection, and group 4 (n = 25) was administered a combination of perianal-intrarectal lidocaine-prilocaine cream. The anaesthetic application was given 5 min before the procedure. All patients were asked to indicate the level of pain experienced on a visual analogue scale (VAS) during three situations, including when the TRUS probe was inserted and 15 min and 2 weeks after biopsy.


RESULTS
Mean pain scores were similar in all groups at the time of probe insertion. Mean pain scores showed statistically significant differences between group 1 and the other groups, except for group 4, 15 min after the procedure. Group 3 showed better pain control 15 min after biopsy and this difference was statistically significant (p < 0.043).The VAS scores were similar 2 weeks after the procedure in all groups.


CONCLUSIONS
Anaesthetic application before TRUS-guided prostate biopsy may be advocated. The application of periprostatic lidocaine seems to be the most advantageous method for lowering the perception of pain.
Gurbuz
Cenk
C
2nd Department of Urology, Istanbul Goztepe Training Hospital, Istanbul, Turkey. gurbuzcenk@yahoo.com
Canat
Lutfi
L
Bayram
Guner
G
Gokhan
Atis
A
Samet
Gungor
G
Caskurlu
Turhan
T
D000287:Administration, Topical; D000368:Aged; D019162:Anesthetics, Combined; D000779:Anesthetics, Local / Q000008:administration & dosage*; D001706:Biopsy; D006801:Humans; D007267:Injections; D008012:Lidocaine / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods*; D011318:Prilocaine / Q000008:administration & dosage; D011467:Prostate / Q000000981:diagnostic imaging* / Q000473:pathology*; D014463:Ultrasonography
D019162:Anesthetics, Combined; D000779:Anesthetics, Local; D011318:Prilocaine; D008012:Lidocaine