title: The Effects of Combination Perianal-Intrarectal Lidocaine-Prilocaine Cream and Periprostatic Nerve Block for Pain Control during Transrectal Ultrasound Guided Biopsy of the Prostate: A Randomized, Controlled Trial.
abstract: OBJECTIVE
  Prostate biopsy for diagnosing cancer can be painful. The efficacy and safety of combination perianal-intrarectal lidocaine-prilocaine (PILP) cream and periprostatic nerve block were compared with nerve block alone during transrectal ultrasound guided prostate biopsy (TRUS-Bx).
  
  
  METHODS
  From October 2007 to August 2009, 74 men undergoing a transrectal prostate biopsy were randomized into two groups. In group 1, 36 patients received a combination of PILP cream and a periprostatic nerve block; and in group 2, 38 patients received lubricant jelly and a periprostatic nerve block. Thirty minutes later, the TRUS-Bx was performed. Pain was evaluated by a 10-point visual analogue scale (VAS) after the biopsy.
  
  
  RESULTS
  Patients in group 1 showed a significantly lower VAS score than patients in group 2 (mean score 2.22+/-0.89 vs. 3.02+/-1.15, p<0.001). In addition, there was a difference in the number of patients that had a pain score of three or more, 44% in group 1, and 65% in group 2. The overall complication rate was similar in both groups (p=0.45).
  
  
  CONCLUSIONS
  A combination of PILP cream and periprostatic nerve block reduced pain compared to the periprostatic nerve block alone. This safe, simple technique can be considered prior to TRUS-Bx to reduce patient discomfort.
authors.affiliation: Department of Urology, Dongguk University Ilsan Hospital, Goyang, Korea.
authors.forename: Dong Hoon
authors.initials: DH
authors.lastname: Noh
authors.forename: Min Chul
authors.initials: MC
authors.lastname: Cho
authors.forename: Hyoung Keun
authors.initials: HK
authors.lastname: Park
authors.forename: Hae Won
authors.initials: HW
authors.lastname: Lee
authors.forename: Kwang Soo
authors.initials: KS
authors.lastname: Lee