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We are quite convinced of the necessity of local anesthesia to decrease pain during transrectal prostate ultrasound guided biopsy. Rectal administration of lidocaine gel is safe, simple and effective even when no difference regarding pain is noted vs lidocaine periprostatic infiltration during the biopsy procedure.

RESULTSThirty-eight (76%) patients developed urinary disorders, but severe urinary complications were exceptional. The International Prostate Symptom Score (IPSS) changed significantly during the first and third month after implantation and then improved during the sixth month. Concomitantly, the maximum and the average urinary flow rate deteriorated significantly. The variations in postvoid residual were less significant. An initial IPSS of >8 and previous a -blocker treatment were identified as significant predictive factors of urinary morbidity, as were the TPBT dose received by 90% of the target volume and by 30% of the urethra, and the volume of prostate receiving 144 Gy. CONCLUSIONUrinary morbidity after TPBT is frequent but rarely exceptionally severe; patients must therefore be given full information. Patients with a higher initial IPSS or having had previous a -blocker treatment, with their associated dosimetric factors, are at greater risk of these urinary morbidity. KEYWORDS brachytherapy, prostate cancer, urinary morbidity OBJECTIVETo assess urinary morbidity within the first 6 months after transperineal prostate brachytherapy (TPBT) with 125 I for localized prostate adenocarcinoma. PATIENTS AND METHODSBetween September 2000 and July 2001, 50 consecutive patients with favourable earlystage prostate cancer were treated with TPBT. Clinical and objective investigations, including uroflowmetry and postvoid residual urine measurements, were evaluated for short-term urinary morbidity; predictive factors were also sought.

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