Which anaesthesia should be recommended for prostate biopsy?

Area of Science:

• Urology
• Anesthesiology
• Pain Management

Background:

• Transrectal ultrasound-guided prostate biopsies often cause significant patient discomfort and pain.
• Current anesthetic practices for these biopsies are inconsistent, with many urologists not employing any form of anesthesia.

Purpose of the Study:

• To compare the efficacy of two local anesthetic techniques for transrectal ultrasound-guided prostate biopsies.
• To evaluate intrarectal lidocaine gel versus periprostatic lidocaine infiltration in managing biopsy-associated pain.

Main Methods:

• A randomized study involving 356 patients undergoing prostate biopsies.
• Group 1 received 15 mL of 2% intrarectal lidocaine gel 10 minutes prior.
• Group 2 received 10 mL of 1% periprostatic lidocaine infiltration 4 minutes prior, with pain assessed using a Visual Analogue Scale (VAS).

Main Results:

• Patients using lidocaine gel reported statistically less pain during anesthesia (VAS 1) and 30 minutes post-biopsy (VAS 3) compared to the injection group.
• No statistically significant difference in pain scores was observed during the biopsy procedure itself (VAS 2).
• Both anesthetic methods were found to be safe, with no major complications reported.

Conclusions:

• Intrarectal administration of lidocaine gel is a safe, simple, and effective anesthetic option for prostate biopsies.
• Lidocaine gel provides more satisfactory pain relief outcomes compared to periprostatic lidocaine infiltration.
• This method offers a viable alternative for improving patient comfort during prostate biopsies.