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Updated: Dec 25, 2025

Transperineal Prostate Biopsy Using a Cone-shaped Double-hole Method with Dual-plane Probe Guidance
Published on: June 6, 2025
Comparison of the Efficacy of Local Anesthesia Methods and Caudal Regional Anesthesia in Prostate Biopsy Applied
Sahin Pasali1, Cuneyt Ozden2, Yalcin Kizilkan3
1Ankara Numune Training and Research Hospital, Department of Urology, Ankara, Turkey. sahinpasali@gmail.com.
Purpose:
To evaluate the efficacy of caudal regional anesthesia and local anesthesia methods in prostate biopsy applied under transrectal ultrasonography. Matherials and Methods: This prospective study included a total of 160 patients randomly separated into 4 equal groups as intrarectal local anesthesia (IRLA), periprostatic local anesthesia (PPLA), combined local anesthesia (IRLA+PPLA), and caudal regional anesthesia (CRA). The patients were evaluated using the pain scores on a visual analog scale.
Results:
The pain score during anesthesia induction was significantly higher in the CRA group than in the IRLA and IRLA+PPLA groups (p<0.001). The pain score during entry of the probe to the rectum and movement was significantly lower in the CRA group than the IRLA groups (p=0.014). The pain score on penetration of the needle to the prostate and at 30 mins after the biopsy was significantly higher in the IRLA group (p<0.001). At 2 hours after the biopsy, the pain score in the CRA group was significantly lower than IRLA groups (p=0.015).
Conclusion:
The PPLA alone can be applied more quickly than CRA, causes less pain during the application, and has similar efficacy in reducing pain during and after the prostate biopsy procedure.
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