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KMID : 0358320100510070463
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Korean Journal of Urology
2010 Volume.51 No. 7 p.463 ~ p.466
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The Effects of Combination Perianal-Intrarectal Lidocaine-Prilocaine Cream and Periprostatic Nerve Block for Pain Control during Transrectal Ultrasound Guided Biopsy of the Prostate: A Randomized, Controlled Trial
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Noh Dong-Hoon
Park Hyoung-Keun
Cho Min-Chul
Lee Hae-Won
Lee Kwang-Soo
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Abstract
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Purpose: Prostate biopsy for diagnosing cancer can be painful. The efficacy and safety of combination perianal-intrarectal lidocaine-prilocaine (PILP) cream and periprostatic nerve block were compared with nerve block alone during transrectal ultrasound guided prostate biopsy (TRUS-Bx).
Materials and Methods: From October 2007 to August 2009, 74 men undergoing a transrectal prostate biopsy were randomized into two groups. In group 1, 36 patients received a combination of PILP cream and a periprostatic nerve block; and in group 2, 38 patients received lubricant jelly and a periprostatic nerve block. Thirty minutes later, the TRUS-Bx was performed. Pain was evaluated by a 10-point visual analogue scale (VAS) after the biopsy.
Results: Patients in group 1 showed a significantly lower VAS score than patients in group 2 (mean score 2.22±0.89 vs. 3.02±1.15, p<0.001). In addition, there was a difference in the number of patients that had a pain score of three or more, 44% in group 1, and 65% in group 2. The overall complication rate was similar in both groups (p=0.45).
Conclusions A combination of PILP cream and periprostatic nerve block reduced pain compared to the periprostatic nerve block alone. This safe, simple technique can be considered prior to TRUS-Bx to reduce patient discomfort.
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KEYWORD
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Analgesia, Biopsy, Pain, Prostate
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