Efficacy of periprostatic local anesthetic for prostate biopsy analgesia: A meta-analysis

Endoscopic therapy of a massive rectal bleeding after prostate biopsy

“…Other researchers have reported intense to intolerable pain at frequencies varying from 22 to 30% [8][9][10]. However, in a recent meta-analysis, significant pain reduction was achievable through a periprostatic local anaesthetic [11].…”

Complications and limitations related to periprostatic local anesthesia before TRUS‐guided prostate biopsy

“…[14][15][16] Despite the fact that lidocaine, an intermediate-acting local anesthetic, has been used in most of the studies on periprostatic local anesthetization, its use in combination with a longer-acting local anesthetic such as bupivacaine has rarely been suggested. Seymour et al 12 emphasized the importance of the spread of the anesthetic agent extensively between the planes of the Denonvillier's fascia for an efficient anesthesia and noted that additional injections would be necessary in a fraction of patients in whom the local anesthetic did not spread freely in that space.…”

Local Anesthesia for the Prostate Gland

“…This study has been supported by many meta-analysis, which have showed a benefit in pain reduction during biopsy with peri-prostatic injection of local anesthetic compared to placebo or no anesthesia. [51][52][53] A recent meta-analysis involving 20 studies and 1685 patients found a significant reduction in pain (weighted mean difference of -2.09, 95% CI -2.44 to -1.75, p<0.0001 on a 10 point scale) when comparing peri-prostatic nerve block to no anesthesia or placebo. 53 These authors found similar benefits for peri-prostatic nerve block over no anesthesia or placebo regardless of the site injected.…”