Effect of periprostatic nerve blockade before transrectal ultrasound‐guided prostate biopsy on patient comfort: A randomized placebo controlled study

Abstract

Background : In the present study, we assessed the efficacy and morbidity of periprostatic local anesthesia before transrectal ultrasound (TRUS)-guided biopsy of the prostate.

A meta-analysis of local anesthesia for transrectal ultrasound-guided biopsy of the prostate

“…In terms of safety, there were no increased complications from biopsy or adverse events from local anesthetic administration reported in all the studies included in the meta-analysis. In addition, Soloway and Obek 12 and others 22,36,40,52 reported no difference in intraoperative findings such as fibrosis or loss of planes between rectum and prostate in patients who underwent prostate biopsies with and without local anesthetic.…”

“…No significant difference between incidence of urethral bleeding (27%, 33%, 22%), hematospermia (30%, 30%, 37%), rectal bleeding (20%, 20%, 17%), infection (2%, 2%, 2%) after the biopsy between CT lidocaine cream and LA groups. Inal [40] No adverse events from LA injection. No significant difference in hematuria and hematochezia between LA and CT. Mallick [43] No difference (LA vs. CT) in hematuria (2% vs. 2%), hematospermia (1% vs. 1%).…”

“…For the 10 trials with placebo injections, concealment of allocation was judged to be adequate with central office randomization in six studies, 35,42,46,55,19,56 but was not used or unclear in the remaining four. 14,40,47,48 For these 10 studies, there was also concern that normal saline placebo injections may cause additional injection-related pain 41 and pain scores from placebo injections alone had been measured to be between 1.1 and 1.8. 51 To address this issue, both types of study controls (no anesthesia as well as placebo injection) were used in two of the studies and no significant difference was found between the mean pain scores of the placebo injection groups and the no anesthesia control groups.…”

“…51 To address this issue, both types of study controls (no anesthesia as well as placebo injection) were used in two of the studies and no significant difference was found between the mean pain scores of the placebo injection groups and the no anesthesia control groups. 14,40 For these two studies, only data between the PPNB and placebo injection Figure 2 Trial and patient characteristics.…”

“…[34][35][36]42,44,[51][52][53]19,56 They were not specified in the remaining 15 trials. 14,[37][38][39][40][41]43,[45][46][47][48][49][50]54,55 For the trials assessing the efficacy of PPNBs, two types of controls were used. Either no anesthesia at all was given or an equivalent volume of normal saline injection was administered.…”