Address of Corresponding Author

Urol Int 2005;74:209-213 (DOI: 10.1159/000083550)

  Key Words

• Prostate biopsy
• Prostate cancer
• Local anesthesia
• Transrectal ultrasound

  Abstract

Introduction: To test the hypothesis that periprostatic block could completely relief prostatic biopsy-associated pain. Materials and Methods: Patients scheduled for transrectal ultrasound guided prostate biopsy were randomized (1:1:1 ratio) to no analgesia (group A), endorectal enema of 1% lidocaine gel (group B) or transrectal periprostatic block (group C). All patients underwent 10 core TRUS-guided biopsy. After the procedure, a ten visual analogue pain score (VAS) from 0 = no discomfort to 10 = severe pain was administered to the biopsied patients and a global estimation of pain associated with the procedure was obtained. The study design included interim analysis of pain score after the first 60 patients were enrolled. Kruskal-Wallis test for unpaired data was used for statistical analysis. Data are presented as mean, median (range). Results: Sixty patients were enrolled between May 2003 and December 2003 and all patients were evaluable. Mean and median age was 68.5 and 69 (range 53-82) years, respectively. Mean and median PSA was 86.8 and 9 ng/ml (range 0.58-4.111), respectively. No major side effects were observed. Patients in group A scored at VAS a median 4, mean 5.5 ± 2.3 (range 3-10). Patients in group B scored a median 4, mean 5.5 ± 2.7 (range 3-10) (p = 0.237). Patients receiving periprostatic injections of carbocaine (group C) scored a median 0, mean 0.5 ± 0.8 (range 0-2). The level of pain reported by this group of patients was significantly different from those reported by patients who performed prostatic biopsy without anesthesia or with intrarectal anesthetic jelly (p = 0.00001). In the periprostatic block group 65% of patients referred no pain after the procedure (VAS = 0) while all patients in the other groups experience some degree of pain. Conclusion: The use of bilateral periprostatic block is a very effective and useful technique, well tolerated by the patient, which almost completely abolishes the pain and discomfort associated with the prostatic biopsy procedure.

Copyright © 2005 S. Karger AG, Basel

  Author Contacts

Dr. Cosimo De Nunzio
Via Sebastiano Grandis 1, sc B
IT-00185 Roma (Italy)
Tel. +39 3389268143, Fax +39 06 80345428, E-Mail cosimodenunzio@virgilio.it

  Article Information

Received: July 19, 2004
Accepted: September 14, 2004
Number of Print Pages : 5
Number of Figures : 2, Number of Tables : 1, Number of References : 16