The rectal administration of lidocaine gel and tolerance of transrectal ultrasonography‐guided biopsy of the prostate: a prospective randomized placebo‐controlled study

Abstract

The rectal administration of lidocaine has no impact on the tolerance to prostatic biopsy.

Pain after transrectal ultrasonography‐guided prostate biopsy: the advantages of periprostatic local anaesthesia

“…Efforts have been reported to control biopsy-related pain; rectal anaesthetic gel was ineffective [1] and the value of an analgesic suppository has not been systematically evaluated, although some use it routinely. Periprostatic LA (both the method of introduction and its value) have not been thoroughly evaluated either.…”

“…This may arise from puncture of the prostatic capsule and stroma, although some men also ®nd the introduction and maintenance of the ultrasound probe within the rectum uncomfortable [5,6]. Previous studies have evaluated the role of anaesthesia (rectal lidocaine gel [1] or periprostatic nerve blockade [5,7]) in improving patient comfort. Of the last two studies only one was a prospective report, but it was a small series [5].…”

Tolerance of pain during transrectal ultrasound-guided biopsy of the prostate: risk factors

“…During transrectal prostate biopsy, the role of anesthesia on pain and tolerance is controversial. [1][2][3][4] Four studies, of which three were prospective and randomized, demonstrated a benefit for pain with local anesthesia. [1][2][3]5 However, a prospective randomized study showed no statistically significant difference on pain between local anesthesia and no anesthesia.…”

“…[1][2][3]5 However, a prospective randomized study showed no statistically significant difference on pain between local anesthesia and no anesthesia. 4 The objectives of our study were to evaluate pain and tolerance of transrectal ultrasoundguided biopsy of the prostate without any anesthesia and to identify a correlation between pain and six parameters: patient age, prostate volume, cores number, operator, previous biopsy and first core location (apex or base).…”

Delayed life-threatening hemorrhage after transrectal prostate needle biopsy

“…[6][7][8][9] A review of recent MEDLINE English literature studies that report on complications of transrectal prostate biopsies and list hematochezia as a complication, showed that of 5911 men biopsied only four required admission for observation of hematochezia, three had oversewing of the rectal mucosa within 2 h of the biopsy to stop bleeding and none required transfusion (Table 1). [10][11][12][13][14][15][16][17] This man had an arterial bleeder that opened 5 days after his biopsy; poorly controlled hypertension and the firm bowel movement most likely contributed to the life-threatening hemorrhage. Neovascularization related to his large volume of disease with high Gleason-grade carcinoma may also have contributed to this patient's excessive bleeding.…”