Local anesthesia during 10 core biopsy of the prostate: comparison of 2 methods

We investigated the effectiveness of a new method, intraprostatic administration of local anesthesia vs traditional periprostatic injection for decreasing the discomfort caused by transrectal ultrasound guided, 10 core biopsy of the prostate.

We studied 71 patients who received intraprostatic anesthesia between October 2002 and March 2003, and 99 who received periprostatic anesthesia between October 2001 and September 2002 before prostate biopsy. After biopsy patients were given a questionnaire, which consisted of 5 questions about pain and 3 about morbidity, and were asked to complete it and mail it to our department.

The mean score +/- SD for the degree of pain during biopsy in the periprostatic groups was 2.6 +/- 1.1 and that in the intraprostatic group was 1.9 +/- 1.1, which was significantly different (p <0.001). Other items, including the degree of pain after biopsy, duration and location of pain, and medicine intake for pain, were not significantly different between the 2 groups. There was no significant difference in morbidity, including hematuria, hemospermia and rectal bleeding, between the 2 groups.

Intraprostatic administration of local anesthesia significantly decreases the pain associated with prostate biopsy compared with periprostatic nerve block. It is a simple, safe and rapid technique that should be considered in all patients undergoing transrectal ultrasound guided prostate biopsy.