[Comparison of two methods of local anaesthesia prior to transrectal ultrasound-guided prostate biopsies]

To compare the analgesic efficacy of rectal administration of Lidocaïne gel with Lidocaïne periprostatic infiltration prior to transrectal ultrasound-guided prostate biopsies.

Between July 2002 and July 2003, candidates to prostate biopsies were randomised into two groups. In group 1, 15 ml 2% Lidocaïne gel was administered intra-rectally 10 minutes prior to biopsies and patients included in group 2 received 10 ml of 1% Lidocaïne in two périprostatique equivalent injections, 4 minutes prior to prostate biopsies. Pain was assessed with a Visual Analog Scale, during anaesthesia (VAS 1), during the biopsies procedure (VAS 2) and 30 minutes after them (VAS 3).

308 patients were included in this trial with 156 patients in group 1 and 152 in group 2. Group 1 experienced statistically less pain for VAS 1 (0.1 versus 1.4, p < 0.0001) and VAS 3 (0.8 versus 1.4, p < 0.001) but no significative difference could be demonstrated for VAS 2 (1.8 versus 2.0). No major complication was noted.

Rectal administration of Lidocaïne gel and infiltration of Lidocaïne lead to a comparable level of anaesthesia during prostatic biopsies procedure. However, the Lidocaïne gel, being both safe and simple, tends to maintain a better comfort of the patient 30 minutes after the end of the biopsies.