Transrectal ultrasound guided multi-core prostate biopsy: pain control: results of 106 patients

To determine the efficacy of periprostatic nerve block (PPNB) for control of transrectal ultrasound (TRUS)-guided multicore prostate biopsy-related pain.

A total of 106 cases with suspicion of prostate cancer underwent TRUS-guided multicore prostate biopsy under local anesthesia using a total of 10 ml of 1% lidocaine for each patient. Lidocaine was injected around the neurovascular bundle at the base of the prostate just lateral to the seminal vesicle-prostate junction. The pain score was assessed using visual analog pain score from 0 to 10. All patients were questioned for whether they would accept repeat biopsy or not, if necessary.

Pain score ranged from 0 to 5 (mean: 1.4). Thirty-five percent (37/106) of patients reported a score of 0, whereas 17% (18/106), 32% (34/106), 8.4% (9/106), 6.7% (7/106), 0.9% (1/106) reported pain scores of 1, 2, 3, 4, and 5, respectively. There were no pain scores of 6-10. Answers for the question "would you accept repeat biopsy or not, if necessary?" was "yes" for 82% (87/106) of the patients.

PPNB prior to multi-core TRUS-guided prostate biopsy is an easy, safe, and effective technique for the control of procedure-related pain.