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Related Experiment Videos

Hypoechoic space formation with periprostatic nerve block: myth or reality?

Can Obek1, Burak Ozkan, Burcin Tunc

  • 1Department of Urology, University of Istanbul Cerrahpasa School of Medicine, Istanbul, Turkey. cobek@yeditepe.edu.tr

Urologia Internationalis
|April 8, 2006
PubMed
Summary

Creating a hypoechoic space during prostate biopsy anesthesia improves pain control. This technique, while not always achieved, significantly reduces patient discomfort, with bilateral formation offering the best pain relief.

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Area of Science:

  • Urology
  • Anesthesiology
  • Medical Imaging

Background:

  • Periprostatic block is a common anesthetic for prostate biopsy.
  • A previously described 'hypoechoic space' at the injection site was thought to be essential.
  • The study aimed to assess the incidence and pain management impact of this hypoechoic area.

Purpose of the Study:

  • To evaluate the occurrence of hypoechoic space formation during periprostatic anesthesia for prostate biopsy.
  • To determine the correlation between hypoechoic space formation and pain intensity during the procedure.

Main Methods:

  • 111 patients undergoing prostate biopsy were prospectively studied.
  • Local anesthetic (2% lidocaine) was infiltrated into the neurovascular space.
  • Hypoechoic nodule formation (none, unilateral, bilateral) was recorded, and pain scores (numeric analog scale) were compared.

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Main Results:

  • No hypoechoic area formed in 27% of patients.
  • Unilateral formation occurred in 36%, and bilateral in 37%.
  • Median pain scores were significantly lower with unilateral (2.5) and bilateral (1.3) formation compared to no formation (3.3) (p<0.0001).

Conclusions:

  • The formation of a hypoechoic space during anesthetic infiltration is important for effective pain control in prostate biopsies.
  • While beneficial, this technique is not consistently achievable in all patients.