A Randomized Prospective Trial of Intrarectal Lidocaine for Pain Control During Transrectal Prostate Biopsy: The Emory University Experience

Abstract

Intrarectal lidocaine gel is a simple, safe and efficacious method of providing satisfactory anesthesia in men undergoing transrectal prostate biopsy. We recommend its routine administration in all patients during this procedure.

Comparison of four different anesthesia methods for relief of all pain during transrectal ultrasound-guided prostate biopsy

“…Several forms of anesthesia during TRUS-guided biopsy decrease erceived pain and improve patient tolerance [4][5][6][7][8][9][10]. However, the optimum method remains unclear.…”

“…There are a number of studies aimed at achieving a pain-free prostate biopsy and to formulate a method that would be feasible for clinical use. The most commonly used analgesia-anesthesia methods for prostate biopsy are periprostatic nerve block [4][5][6][7], intrarectal anesthetic gel administration [8,9], and pudental nerve block [10]. Anal discomfort due to the ultrasound probe and insertion of needles through the prostate gland are usually responsible for pain during prostate biopsy [11].…”

Prevention of Pain and Infective Complications after Transrectal Prostate Biopsy: A Prospective Study

“…For this reason, prostatic nerve blockage and local anesthetics such as intrarectal lidocaine gel are used prior to the procedure in order to decrease discomfort and pain. There are a number of studies that support the superiority of intrarectal lidocaine gel [11][12][13], while there are also several suggesting that it makes no difference in terms of pain experienced during the procedure [1,2,14]. During systematic prostate biopsy accompanied by transrectal ultrasonography, it is reported that 65-90% of patients experience procedure-related pain [3].…”

“…Irani et al report an average VAS score of 4 in a study in 81 patients who received no anesthesia [15]. Issa et al, in a study in which they administered lidocaine intrarectally, stated that this procedure is simple, safe, and effective [11]. In a randomized prospective study, Alavi et al found the pain score for periprostatic lidocaine injection to be lower than that for intrarectal lidocaine injection [1].…”

Local Anesthesia During Transrectal Ultrasonography-guided Prostate Biopsy: does it have any Effect on Sexual Function?

“…However, it has a considerable impact on patient well being that starts before and lasts for weeks after the procedure [4]. Pain and great discomfort are common complaints of patients despite the wide use of automatic spring-loaded biopsy guns [8]. Lately, it seems that an increasing number of urologists administer some form of anesthesia in order to minimize the unwanted side effects of prostate biopsy.…”