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Local anaesthetic for transrectal ultrasound-guided prostate biopsy: a prospective, randomized, double blind,
S K Addla1, A A B Adeyoju, G D Wemyss-Holden
1Department of Urology, Blackburn Royal Infirmary, Blackburn, BB2 3LR, UK. saddla@yahoo.co.uk
Objective:
To evaluate the efficacy of local anaesthetic (LA) infiltration in decreasing the discomfort experienced by patients undergoing transrectal ultrasound (TRUS)-guided biopsy of prostate.
Patients And Methods:
98 patients were randomized to receive 3x3ml of 1% lidocaine (n=55) or saline (n=43). The injection sites were basolaterally on each side to infiltrate the neuro-vascular bundle and one at the apex. Generally 12 systematic random biopsies were performed after which patients were asked to grade the pain of the whole procedure using a visual analogue scale ranging from 0 to 10.
Results:
The LA group had a significantly lower pain score compared with placebo. The mean pain scores were 3.0 and 4.3 (p<0.001), respectively. Using an unpaired t-test, the difference between means was -1.96 to -0.51 with 95% confidence interval. There were no significant problems associated with the infiltration of either saline or LA.
Conclusion:
Local anaesthesia for TRUS biopsy is simple and well tolerated. It significantly reduces the pain associated with the procedure. We recommend its usage as a part of standard TRUS biopsy of the prostate.