Neuroanatomy of the male rhabdosphincter

Hollabaugh, Robert S.; Dmochowski, Roger R.; Steiner, Mitchell S.

doi:10.1016/s0090-4295(96)00497-9

Cited by 181 publications

(83 citation statements)

References 18 publications

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“…The nerves pass along the plane between the rectum and prostatic capsule. The pain associated with prostate biopsy is thought to be contributed to by direct contact of the biopsy needle with these nerves within the stroma and the prostatic 'capsule', which are richly innervated [13].…”

Section: Discussionmentioning

confidence: 99%

Does pericapsular lignocaine reduce pain during transrectal ultrasonography‐guided biopsy of the prostate?

Walker¹,

Schelvan²,

Rockall

et al. 2002

BJU International

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Objective To evaluate whether injection with pericapsular lignocaine before transrectal ultrasonography (TRUS)-guided biopsy reduces the perceived pain of prostatic biopsy. Patients and methods The study included 121 patients referred for TRUS-guided biopsy of the prostate; 27 underwent biopsy with no previous injection and 94 were randomized to pericapsular injection with either 1% lignocaine or a placebo (saline). Both patient and operator were unaware of the content of the injection. The injection was delivered under TRUS guidance to the apex of the prostate. Routine sextant biopsies were taken using an 18 G needle in a spring-loaded biopsy gun. A validated pain scale, the NRS11 (0, no pain, to 10, unbearable pain), was used to record the pain of each biopsy.Results No significant placebo effect was detected between the 'no injection' and the placebo-injection group, with mean (95% confidence interval) pain scores of 3.58 (2.77-4.39) and 4.01 (3.46-4.51), respectively, using the unpaired Student's t -test ( P = 0.409). There was a statistically significant lower mean pain score in the lignocaine group, at 2.54 (2.00-3.10), than in the placebo-injection group ( P < 0.001). Conclusion Pericapsular injection with 1% lignocaine significantly reduces the perceived pain of TRUS-guided prostatic biopsy.

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Section: Discussionmentioning

confidence: 99%

Does pericapsular lignocaine reduce pain during transrectal ultrasonography‐guided biopsy of the prostate?

Walker¹,

Schelvan²,

Rockall

et al. 2002

BJU International

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“…32,33 A total of 25 trials were eventually evaluated. 19,56,57 Trials identified as potentially relevant and screened (n= 61) Trials retrieved for detailed evaluation (n=42) Trials excluded as not relevant (n=19)…”

Section: Study Selectionmentioning

confidence: 99%

“…Sensory fibers from the prostatic capsule convey pain sensation via ramifications within the prostatic plexus, which subsequently travel with the prostatic vascular pedicles at the posterolateral border of the prostate. 57 Infiltration of the local anesthesia around these neurovascular bundles achieves its anesthetic effect. Nash et al 14 initially described the technique of single local anesthestic injection, on each side of the prostate, into the region of the prostatic pedicle at the base of the prostate just lateral to the junction between the prostate and seminal vesicles.…”

Section: Periprostatic Nerve Blockmentioning

confidence: 99%

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

Tiong

Liew

Samuel

et al. 2007

Prostate Cancer Prostatic Dis

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This meta-analysis evaluated the efficacy and safety of periprostatic nerve block (PPNB) and intrarectal local anesthestic (IRLA) gel in alleviating pain during prostate biopsy. Electronic databases MEDLINE, Cochrane Central Register of Controlled Trials and EMBASE were searched to identify all randomized controlled trials comparing PPNB with periprostatic placebo injection, no injection or with IRLA. Studies for inclusion were identified and extracted by two authors independently. The main outcome measure was patients' assessment of mean pain scores on a 10-point scale at the end of the biopsy procedure. Secondary outcomes were complications and adverse events. Continuous data from the trials were combined by calculating the weighted mean difference (WMD) with its 95% confidence interval. In total, 25 studies met the inclusion criteria. Twenty studies involving 1685 patients compared PPNB with either no anesthesia or with placebo injection controls, showing a significant reduction in pain score in the anesthetic group (WMD À2.09, 95% CI À2.44 to À1.75, Po0.00001). Five studies with 466 patients compared IRLA and control. Although IRLA was associated with pain reduction, the effect size was not statistically significant (WMD À0.22, 95% CI À0.56 to 0.12). Six studies with 872 patients compared PPNB with IRLA, showing a significant pain reduction in the former group (WMD À1.53, 95% CI À2.67 to À0.39, P ¼ 0.008). No trials reported an increase in complications in the treatment arms. In conclusion, the evidence from randomized controlled trials shows that local anesthetic given as a PPNB, but not as an intrarectal instillation, is effective and safe in alleviating pain from transrectal ultrasound biopsy of the prostate.

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“…The perforation of prostate capsule with biopsy needle mainly generates the pain that is transmitted through the neurovascular bundles. The nerves with sensorial innervations of prostate capsule and stroma pass through the posterolateral border of the prostate capsule at prostatic base (11,16,17,18). Local anesthesia is widely used to reduce the pain and discomfort of patients during TRUS guided PBx (11,19).…”

Section: Discussionmentioning

confidence: 99%

The Optimum Dosage of Prilocaine in Periprostatic Nerve Block During Transrectal Ultrasound Guided Prostate Biopsy: A New Approach in Dose Calculation

Gonulalan¹,

Kosan²,

Kervancioglu³

et al. 2016

uob

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ÖzAmaç: Amacımız transrektal ultrason (TRUS) kılavuzluğunda yapılan prostat biyopsisinde (PB) uygulanan periprostatik sinir blokajında (PPSB) prostat hacmi başına en uygun prilokain dozunun hesaplanmasıdır. Gereç ve Yöntem: 2011-2013 yılları arasında 12 kor TRUS kılavuzluğunda PB alınan 83 hastanın tıbbi kayıtları geriye dönük incelendi. Prostat boyutu, aksiyel planda antero-posterior (Boyut 1) ve transvers ölçüm (Boyut 2) ve sagittal planda kraniyo-kaudal ölçüm (Boyut 3) kullanılarak hesaplandı. TRUS-PB esnasındaki visual analog skala (VAS), prostat hacimleri ve 1 ml prostat hacmi başına uygulanan prilokain dozu değerlendirildi. Hastaların VAS ile prostat hacimleri, prostat boyutları ve uygulanan prilokain dozları arasındaki korelasyon Cubic regresyon testi ile hesaplandı. Bulgular: VAS ile prostat boyut 1, 2, 3 ve prostat hacmi arasında anlamlı olarak pozitif korelasyon mevcuttur (p<0,05). Ancak VAS ile 1 ml prostat hacmi başına prilokain dozu arasında anlamlı olarak negatif korelasyon mevcuttur (r=-0,402, p<0,01). Kübik regresyon formülüne göre TRUS kılavuzluğunda PB sırasında hafif ve rahatsız etmeyen ağrı düzeyi (VAS<2) için PPSB sırasında yapılması gereken maksimum prilokain dozu 1 ml prostat hacmi başına 0,1 ml prilokain infiltrasyonudur. Sonuç: TRUS kılavuzluğunda PB sırasında saptanan VAS, prilokain dozu, prostat hacmi ve özellikle antero-prosterior ve kraniyo-kaudal prostat boyutlarından anlamlı olarak etkilenmektedir. TURS kılavuzluğunda PB esnasındaki ağrı 1 ml prostat dokusu başına 0,1 ml prilokain dozu ile etkin olarak kontrol edilebilmektedir. Anahtar Kelimeler: Ağrı, prilokain, prostat, periprostatik sinir blokajı, transrektal ultrason SummaryObjective: We aimed to calculate the optimum dose of prilocaine per one mL prostate volume in periprostatic nerve block (PPNB) during transrectal ultrasound (TRUS) guided prostate biopsy (PBx). Materials and Methods:We retrospectively evaluated the medical records of 83 patients from whom 12 cores TRUS guided PBx were obtained between years 2011 and 2013. Prostatic sizes were evaluated separately as Size 1 (anterior-posterior on the axial plane), Size 2 (transversal), and Size 3 (cranial-caudal on the sagittal plane) for all patients. The visual analog scores (VAS) of the patients during PBx, prostatic volumes, and prilocaine doses per one mL prostate were evaluated. The correlation between VAS of patients during PBx and prostatic volume, the prostatic sizes and prilocaine dosage per one mL prostate was analyzed using Cubic regression test. Results: It was found that VAS scores of patients were significantly positive correlated with prostatic volume, Size 1, 2 and 3 (p<0.05). However, there was a negative significant correlation between VAS and prilocaine dose per one mL prostate volume (r=-0.402, p<0.01). The dose of 0.1 mL prilocaine infiltration per one mL prostatic tissue in PPNB was the maximum dose that caused a mild and under annoying pain (VAS<2) in patients according to cubic regression formula. Conclusion: Prilocaine dosage, prostatic volume and pr...

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Neuroanatomy of the male rhabdosphincter

Cited by 181 publications

References 18 publications

Does pericapsular lignocaine reduce pain during transrectal ultrasonography‐guided biopsy of the prostate?

Does pericapsular lignocaine reduce pain during transrectal ultrasonography‐guided biopsy of the prostate?

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

The Optimum Dosage of Prilocaine in Periprostatic Nerve Block During Transrectal Ultrasound Guided Prostate Biopsy: A New Approach in Dose Calculation

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