USE OF INTRARECTAL LIDOCAINE GEL DURING TRANSRECTAL ULTRASONOGRAPHY GUIDED PROSTATE BIOPSY: A DOUBLE BLIND, RANDOMIZED, PLACEBO CONTROLLED STUDY ON PATIENT’S TOLERANCE

Introduction: In our study we evaluated the effect of intrarectal lidocaine gel versus gel without lidocaine in prostate biopsy on the patient tolerance.

Materials and Methods: 65 patients, with an average age of 67 (51-83) years who were advised to undergo TRUS guided prostate biopsy between January and June 2002 in our clinic, were included in our study. Randomize two groups were formed as group A (33), group B (32). Classical six quadrant biopsy was performed 10 minutes after the application of rectal 2% lidocaine gel in group A and normal gel without lidocaine in group B. Patients who needed more than 6 quadrant biopsy were excluded from the study. Following the procedure patients were taken to another room where their tolerance was evaluated by the doctors who did not performed the biopsy. Visual analog scala (VAS) was utilized to evaluate the tolerance; rating from 0 (no pain) to 10 (unendurable). Results were statistically evaluated.

Results: Similar rates were observed with VAS evaluation of the patients in two groups. The mean pain score was 2.9±2.0 VAS in lidocaine group, 3.0±2.1 VAS in the ultrasonic gel. This difference was not statistically significant (Mann-Whitney test p=0.811).

Conclusion: We found out that, use of intrarectal lidocaine gel, which is believed to be convenient anesthethi technique in sustaining both patient and doctors comfort while performing TRUS guided prostate biopsy, does not significantly effect the pain tolerance. For this reason alternative techniques should be preferred.