The comparison of three different analgesia methods during the transrectal ultrasound guided prostate biopsy

Objective: In this prospective randomized study we compared the efficiency ofthree different anesthetic tecniques transrectal ultrasound(TRUS) guided prostate biopsy.Material and Method: TRUS guided 12 core prostate biopsy were performed on 100suitable patients with the study criteria between October 2007?March 2008. Patients wererandomized to 4 groups each containing 25 patients. The groups were, group 1: noanesthesia, group 2: periprostatic blockage, group 3: intrarectal gel instillation and group 4:sedoanalgesia. Pain scores were evaluated during needle biopsy(VAS1), just after thebiopsy procedure(VAS2) and 1 hour after biopsy(VAS3).Results: There were no statistically significant differences between four groups interms of mean age and PSA values.Statistically significant differences were determinedbetween groups, when VAS1, VAS2, VAS3 pain scores were compared(p=0.001).Although, the pain scores were high in group 1 and group 3, the difference was notsignificant (p>0.05). In group 1 and 2 there were significant decrease in VAS1 and VAS2. The pain scores were significantly lower in sedoanalgesia group than other 3 groups(p=0.0001). When group 2 and 3 were compared, decreasing of VAS1, VAS2 and VAS3scores in group 2 were significant. When PPB and intrarectal gel group was compared tosedoanalgesia group, there was statistically significant decrease in VAS1, VAS2 and VAS3 scores in sedoanalgesia group(p=0.0001).Conclusion: It is crucial to control pain and discomfort in patients during TRUSguided prostate biopsy. In this study, it was shown that patient comfort is better and it ispossible to get decreased pain scores with periprostatic blockage or sedoanalgesia.