Urology Research & Practice
Original Article

Comparison of two different doses of lidocaine on the pain sensation during transrectal ultrasound-guided prostate biopsy

1.

Department of Urology, Gülhane Military Medical Academy Haydarpaşa Training Hospital, İstanbul, Turkey

2.

Department of Urology, Gümüşsuyu Military Hospital, İstanbul, Turkey

3.

Department of Anesthesia, Gülhane Military Medical Academy Haydarpaşa Training Hospital, İstanbul, Turkey

4.

Department of Urology, Hakkari Military Hospital, Hakkari, Turkey

Urol Res Pract 2016; 42: 145-149
DOI: 10.5152/tud.2016.38107
Read: 1835 Downloads: 1109 Published: 25 July 2019

Abstract

Objective: To compare two different doses of lidocaine used for periprostatic nerve block on pain perception during transrectal ultrasound (TRUS) guided prostate biopsy.

 

Material and methods: A total of 288 patients with elevated prostate specific antigen (PSA) levels and/or abnormal digital rectal examination who underwent TRUS-guided prostate biopsy were included in the study. The patients were divided into 3 groups: Group 1 (n=103) prostate biopsy were performed after administering perianal intrarectal application of 10 mL 2% lidocaine gel, Group 2 (n=98) 2 mL of 2% lidocaine injection on each side following rectal installation of lidocaine gel and Group 3 (n=87) 4 mL of 2% lidocaine injection on each side after rectal instillation of lidocaine gel. Patients’ pain scores during biopsy procedure were reported using visual analogue score (VAS). Independent sample t test, ANOVA test and Tukey test were used for statistical evaluation.

 

Results: The mean age, prostate volume and PSA level were 65.6±8.4 years, 58.2±34.8 mL, and 11.8±3.4 ng/mL respectively. There were no statistically significant differences in baseline characteristics between the groups. The mean VAS scores were 2.4±1.8 in Group 1, 2.5±1.9 in Group 2 and 1.6±1.6 in Group 3. Patients in Group 3, reported significant pain reduction compared with patients in Groups 1 and 2 (p=0.002, and 0.001, respectively). However, there was no statistically significant difference in VAS scores between Groups 1 and 2 (p=0.815).

 

Conclusion: According to our results we recommend the use of perianal intrarectal lidocain gel application, and periprostatic nerve block with injection of 4 ml 2% lidocaine per side combination in TRUS-guided prostate biopsies. Further large-scale randomized control studies are needed to validate these finding.

Files
EISSN 2980-1478