The Comparison of Periprostatic Nerve Blockage with the Combination of Perianally and Intrarectally Lidocaine Gel and Intrarectally Indomethacin Suppository in the Control of Pain Related to Transrectal Ultrasound Guided Prostate Biopsy Procedure - Pages 20-24

Ayhan Karakose1, Mehmet Bilgehan Yuksel2, Yusuf Ziya Atesci1 and Bilal Gumus2

1Department of Urology, Izmir University School of Medicine, Izmir, Turkey; 2Department of Urology, Celal Bayar University, School of Medicine, Manisa, Turkey



Aims: In this study, we aimed to evaluate the effectiveness of the use of periprostatic nerve blockage with the combination of perianally and intrarectally lidocaine gel and intrarectally indomethacin suppository in the control of pain related to the TRUS-Bx procedure.

Materials and Methods: The data of 88 patients who underwent TRUS-Bx were retrospectively evaluated. The sample were divided in two groups according to the type of topical anesthesia previous to TRUS-Bx. In group 1 (n=42), while the combination of perianally and intrarectally lidocaine gel with intrarectally indomethacin suppository were applied to provide local anesthesia, a periprostatic nerve blockage by using 10 ml of %1 lidocaine solution were also performed in addition to this combination in group 2 (n=46). Ten point linear visual analog scale (VAS) was used to evaluate the pain. While VAS-1 score evaluated the pain that occured during TRUS probe placement and/or manipulations, VAS-2 score analysed the pain that occurred during the performation of needle biopsy.

Results: The mean ages, PSA values, and prostate volumes were similar between two groups (P= 0.437, P= 0.187, P= 0.194; respectively). The analysis of the pain related to TRUS probe placement and manipulation showed that VAS-1 score was found 2.72 ± 0.7 and 2.68 ± 08, respectively. The comparison of VAS-1 scores revealed that there was no statistically significant difference between two groups. Nevertheless, VAS-2 score, which evaluated the pain during the needle biopsy, was determined 5.36 ± 1.08 in group 1 and 2.13 ± 0.76 in group 2. It was found that VAS-2 score was significantly lower in group 2 (P= 0.001).

Conclusion: Our study revealed that periprostatic nerve blockage provided additional improvement in the control of pain related to only the step of needle biopsy in TRUS-Bx procedure.

Keywords: Transrectal prostate biopsy, Periprostatic nerve blockage, Topical anesthetic gel, Pain, Visual analog scale.