Related Experiment Video
Updated: May 12, 2026
Transperineal Prostate Biopsy Using a Cone-shaped Double-hole Method with Dual-plane Probe Guidance
Published on: June 6, 2025
A prospective randomized trial comparing three different analgesic techniques for pain control during transrectal
1Department of Urology, V.M. Medical College and Safdarjang Hospital, New Delhi, India. anup_14k@yahoo.com
Aim:
The aim of this paper was to optimize pain control during transrectal ultrasound (TRUS) guided prostate biopsy, the efficacy and safety of three different analgesic techniques were compared.
Methods:
Two hundred and forty patients were prospectively randomized into 3 groups before TRUS guided prostate biopsy. Group A received combined periprostatic nerve block (PPNB) and perianal-intrarectal lidocaine-prilocaine (PILP) cream; group B: PILP cream; group C: PPNB. Pain was evaluated using 10-point Visual Analog Scale (VAS).
Results:
VAS during TRUS was lower in groups A and B vs. C (mean 1.3,1.4 vs. 5.1, P<0.001); VAS for PPNB was lower in group A and group B vs. C (mean 1.1,1.3 vs. 3.5, P<0.001). VAS for sampling wase lower in group A as compared to B and C (mean 0.6, 3.5 and 1.4, P<0.001). VAS on stratified analysis was significantly lower in groupA vs. B and C in patients <60 years, prostate >50 cc and those with lower anorectal compliance (P<0.001). The overall complication rate was similar in all three groups.
Conclusion:
The combination of PILP and PPNB provides better analgesia, especially in patients <60 years, prostate volume >50 cc and lower anorectal compliance as compared to two modalities used alone during the sampling part of TRUS guided prostate biopsy with no increase in the complication rate.
