Is only perianal anesthesia with lidocaine-prilocaine cream sufficient to decrease the pain during transrectal...

Area of Science:

• Urology
• Anesthesiology
• Pain Management

Background:

• Prostate biopsy is an essential diagnostic procedure.
• Pain and discomfort are common patient experiences during prostate biopsies.
• Optimizing local anesthesia can improve patient tolerance and procedural outcomes.

Purpose of the Study:

• To identify the optimal application site for local anesthetic cream.
• To evaluate the efficacy of lidocaine-prilocaine cream for pain reduction during prostate biopsy.
• To compare perianal versus intrarectal versus combined application of the anesthetic cream.

Main Methods:

• Eighty patients undergoing prostate biopsy were randomized into four groups: control, perianal cream, intrarectal cream, and combined perianal/intrarectal cream.
• Lidocaine-prilocaine cream was applied topically in varying locations based on group assignment.
• Pain scores were assessed during probe insertion, the biopsy procedure, and overall, with statistical comparison of mean scores between groups.

Main Results:

• The control group reported significantly higher pain during probe insertion compared to biopsy.
• Perianal application (group 2) and combined application (group 4) significantly reduced pain during probe insertion compared to the control group.
• No significant differences in overall pain scores were observed between the control and intrarectal cream groups, but both differed significantly from the perianal and combined application groups.

Conclusions:

• Perianal anesthesia using lidocaine-prilocaine cream appears sufficient for reducing pain during the probe insertion phase of prostate biopsy.
• Targeting perianal application may offer an effective and potentially simpler strategy for pain management in prostate biopsies.