Joon Se Jung1, Hee Nam Moon2, Jung Im Kim3, Sang Rak Bae4, Chang Hee Han4, Bong Hee Park5. 1. Department of Urology, Armed Forces Hongcheon Hospital, Ministry of National Defense, Seoul, Republic of Korea. 2. Department of Nursing, Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea. 3. Department of Radiology, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, Republic of Korea. 4. Department of Urology, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. 5. Department of Urology, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. bhparkuro@catholic.ac.kr.
Abstract
PURPOSE: To determine whether intrarectal local anesthesia (IRLA) with heated lidocaine gel provides pain reduction during transrectal ultrasound (TRUS)-guided prostate biopsy. METHODS: We conducted a randomized-controlled study with 153 participants who underwent TRUS-guided, systematic 12-core prostate biopsy from May 2018 to June 2019. These participants were divided into three test groups. Before prostate biopsy, group A (51 patients) received no local anesthesia, group B (51 patients) received IRLA with 20 mL 2% lidocaine gel stored at room temperature, and group C (51 patients) received IRLA with heated (40 ℃) 20 mL 2% lidocaine gel. Pain was assessed using the 0-10 visual analogue scale (VAS) at three time points: VAS-1: during probe insertion, VAS-2: during biopsy, VAS-3: 30 min after the procedure. Complications during and after the procedure were evaluated. RESULTS: The mean VAS-2 score was significantly lower in group C compared to groups A and B (A, 4.6; B, 4.2; and C, 3.2; p < 0.05). There was no significant difference among the three groups in mean VAS-1 and VAS-3 scores. No significant difference was detected in incidence of complications between the three groups. No allergic reactions to lidocaine gel were observed. CONCLUSION: IRLA with heated lidocaine gel provides more effective pain control during TRUS-guided prostate biopsy than does conventional IRLA and no local anesthesia, without an increase of complications.
PURPOSE: To determine whether intrarectal local anesthesia (IRLA) with heated lidocaine gel provides pain reduction during transrectal ultrasound (TRUS)-guided prostate biopsy. METHODS: We conducted a randomized-controlled study with 153 participants who underwent TRUS-guided, systematic 12-core prostate biopsy from May 2018 to June 2019. These participants were divided into three test groups. Before prostate biopsy, group A (51 patients) received no local anesthesia, group B (51 patients) received IRLA with 20 mL 2% lidocaine gel stored at room temperature, and group C (51 patients) received IRLA with heated (40 ℃) 20 mL 2% lidocaine gel. Pain was assessed using the 0-10 visual analogue scale (VAS) at three time points: VAS-1: during probe insertion, VAS-2: during biopsy, VAS-3: 30 min after the procedure. Complications during and after the procedure were evaluated. RESULTS: The mean VAS-2 score was significantly lower in group C compared to groups A and B (A, 4.6; B, 4.2; and C, 3.2; p < 0.05). There was no significant difference among the three groups in mean VAS-1 and VAS-3 scores. No significant difference was detected in incidence of complications between the three groups. No allergic reactions to lidocaine gel were observed. CONCLUSION: IRLA with heated lidocaine gel provides more effective pain control during TRUS-guided prostate biopsy than does conventional IRLA and no local anesthesia, without an increase of complications.
Authors: Ferhat Ateş; Furkan Dursun; Ercan Malkoç; Ömer Yılmaz; Hasan Soydan; Hüseyin Şen; Şeref Başal; Fatih Zekey; Kenan Karademir Journal: Turk J Urol Date: 2016-09
Authors: Alexander P Kenigsberg; Audrey Renson; Andrew B Rosenkrantz; Richard Huang; James S Wysock; Samir S Taneja; Marc A Bjurlin Journal: Eur Urol Oncol Date: 2018-10-05