title: Local anesthesia type affects cancer detection rate in transrectal ultrasound guided prostate biopsy.
abstract: OBJECTIVE
  Studies about the anesthesia techniques during transrectal ultrasound guided prostate biopsy (TRUS-Bx) are usually focused on pain relief. Although patients' tolerance is an important issue in TRUS-Bx, cancer detection rate (CDR) must not be ignored. In this study, we compared the impact of intrarectal lidocaine gel anesthesia (IRLA) and periprostatic nerve blockade (PNB) techniques on CDR.
  
  
  METHODS
  A total of 422 patients underwent 10 core-TRUS-Bx because of elevated serum prostate specific antigen (PSA) level (>2.5ng/mL) and/or suspicious digital rectal examination findings. Patients were divided into two groups according to the applied anesthesia technique: IRLA group and PNB group. Age, serum PSA level, prostate volume, visual analogue scale (VAS) score and CDR were recorded and compared statistically with chi square and unpaired t-tests.
  
  
  RESULTS
  Of the patients 126/422 (29.9%) underwent TRUS-Bx by using IRLA whereas 296/422 (70.1 %) by PNB technique. The mean, age, serum PSA level and prostate volume were similar between the two groups. CDR was 19.8% and 25.4% in IRLA and PNB groups, respectively (p=0.001). The mean VAS score of the PNB group (1.84±0.89) was significantly lower than that for IRLA group (3.62±1.06) (p=0.001).
  
  
  CONCLUSIONS
  Our results revealed that PNB is superior to IRLA in terms of CDR. Further studies are required to confirm our findings.
authors.affiliation: Department of Urology, Bitlis State Hospital, Besminare, Bitlis, Turkey.
authors.forename: Mustafa Zafer
authors.initials: MZ
authors.lastname: Temiz
authors.affiliation: Department of Urology, Bagcilar Training and Research Hospital, 6. Sokak, Bagcilar/Istanbul, Turkey.
authors.forename: Engin
authors.initials: E
authors.lastname: Kandirali
authors.affiliation: Department of Urology, Bagcilar Training and Research Hospital, 6. Sokak, Bagcilar/Istanbul, Turkey.
authors.forename: Aykut
authors.initials: A
authors.lastname: Colakerol
authors.affiliation: Department of Urology, Bagcilar Training and Research Hospital, 6. Sokak, Bagcilar/Istanbul, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Tuken
authors.affiliation: Department of Urology, Bagcilar Training and Research Hospital, 6. Sokak, Bagcilar/Istanbul, Turkey.
authors.forename: Atilla
authors.initials: A
authors.lastname: Semercioz
mesh_terms: D000285:Administration, Rectal; D000368:Aged; D000772:Anesthesia, Local / Q000379:methods*; D000779:Anesthetics, Local / Q000627:therapeutic use*; D001707:Biopsy, Needle / Q000379:methods*; D005782:Gels; D006801:Humans; D008012:Lidocaine / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000473:pathology*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D018084:Ultrasonography, Interventional / Q000379:methods*; D064232:Visual Analog Scale
chemical_list: D000779:Anesthetics, Local; D005782:Gels; D008012:Lidocaine; D017430:Prostate-Specific Antigen