Evaluation of the efficacy of periprostatic and intraprostatic local anasthesia in 12-core transrectal ultrasonography guided prostate biopsies

8. SUMMARYEvaluation of the efficacy of periprostatic and intraprostatic local anasthesia in 12-coretransrectal ultrasonography guided prostate biopsiesObjectiveTRUS guided application of prostate biopsies is accepted as the gold standard forhistological diagnosis of prostate cancer. Recently, an increase in the number of cores haswidely been suggested. In fact this approach augments the need for analgesia during thebiopsy procedure. Various strategies for the control of pain in prostate biopsies have beendefined with no standard application. In this current study, the efficacy of addingintraprostatic lidocaine injection to the periprostatic application in 12 core TRUS guidedprostate biopsies was assessed.Materials and MethodsThe patients were randomly divided into 2 groups with 30 patients in each one after bilateralinjection of periprostatic lidocain with the total dose of 10 ml. Consequently, the first groupreceiving intraprostatic 10 ml lidocain while the second group had intraprostatic 10 mlinjectitional salin. The pain scores of these two groups were compared by using visualanalog linear 11-point scale.ResultsBoth groups were similar with regard the age, PSA and prostate volumes. Similarly nodifference was observed in mean pain scores related to both intramuscular injection andprobe insertion. The mean pain score of the biopsy procedure in the first group receivingintraprostatic lidocaine injection was 0.62±0.96 while it was 2.34±1.83 in the second grouphaving salin. This difference in pain control was statistically significant. No remarkablecomplication was observed in both groups.ConclusionsThe results of this prospective, randomised clinical trial suggest that the addition ofintraprostatic lidocaine injection to the periprostatic lidocaine application remarkablyincreases the pain control in patients with 12 core TRUS guided prostate biopsies. It can beconcluded that intraprostatic injections may be included in routine clinical practice.Key words: TRUS, prostate biopsy, intraprostatic, periprostatic, analgesia, prostate cancer