Comparison of Intrarectal Lidocaine Gel, Intrarectal Ultrasonic Gel and Periprostatic Nerve Blockage in Terms of Patient Pain Tolerance in Prostate Biopsy With Transrectal Ultrasound

Gökhan Çevik, Mustafa Ozan Ataçer

Keywords: Intrarectal local anesthesia; periprostatic nerve block; prostate biopsy.

Aim:

Prostate biopsy is the gold standard method used in the diagnosis of prostate cancer. While periprostatic injection of local anesthetic agents during this procedure is the most effective method for reducing pain during the prostate biopsy, there are studies indicating that application of a local anesthetic agent to the rectum is also an effective method. In this study, we compared the effectiveness of intrarectal lidocaine gel, intrarectal ultrasonic gel and lidocaine administered to the periprostatic region in pain reduction before taking prostate biopsy in our patients with prostate biopsy indication.

Method:

In our study, 100 volunteer patients with prostate biopsy indication were included with TUTF-BAEK2019/203 approval number of Trakya University Faculty of Medicine Ethics Committee. These patients were randomly divided into four groups of 25. Groups were named A, B, C and D. A standard 12-piece prostate biopsy was performed with a tru-cut biopsy needle from all patients. After the procedure, the patient's pain tolerance was
evaluated by a different individual. The VAS scale was used to assess pain tolerance.

Results:

A statistically significant difference was also found between the groups regarding the visual pain scores in all three stages. When STAI-I of the patients participating in this study was compared, there was no significant difference among the four groups. In our study, no significant relationship was found between pre-procedure anxiety and pain during and after the procedure.

Conclusions:

During prostate biopsies, only periprostatic blockade with lidocaine was not sufficient at the time of introduction of the probe, causing patients to feel pain, therefore, combined with periprostatic blockage with intrarectal lidocaine gel, it has been shown that it increases patient comfort and has the lowest VAS scores in all three stages of biopsy.

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