Transrectal periprostatic lidocaine injection anesthesia for transrectal prostate biopsy: a prospective study

Area of Science:

• Urology
• Anesthesiology
• Oncology

Background:

• Transrectal ultrasound (TRUS)-guided biopsy is standard for prostate cancer diagnosis.
• Many patients experience significant discomfort and pain during TRUS-guided prostate biopsy.
• Effective pain management is crucial for patient tolerance and adherence to diagnostic procedures.

Purpose of the Study:

• To evaluate the effectiveness of periprostatic nerve block with lidocaine for pain management during TRUS-guided prostate biopsy.
• To compare pain scores between patients receiving lidocaine injection and those receiving a placebo.

Main Methods:

• Prospective study involving 100 patients undergoing TRUS-guided prostate biopsy.
• Group I (50 patients) received 10 cm³ of 1% lidocaine injected into the periprostatic nerve plexus.
• Group II (50 patients) received a placebo injection; pain was assessed using a 10-point modified visual analog scale (VAS).

Main Results:

• The mean VAS pain score was significantly lower in the lidocaine group (1.46) compared to the placebo group (4.5) (P=0.0001).
• No patients in the lidocaine group reported a VAS pain score of 5 or higher.
• No statistically significant differences were observed in age, tPSA, or biopsy duration between the groups.

Conclusions:

• Periprostatic nerve block with lidocaine is a simple, safe, and cost-effective method for pain management during TRUS-guided prostate biopsy.
• This anesthesia technique significantly reduces patient-reported pain without prolonging the procedure.
• The study supports the routine use of periprostatic nerve blocks for TRUS-guided prostate biopsies.