Korean J Urol.  2010 Jul;51(7):463-466.

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

• Noh DH
• Cho MC
• Park HK
• Lee HW
• Lee KS

Abstract

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.

Keyword

Analgesia; Biopsy; Pain; Prostate

MeSH Terms

Analgesia
Biopsy*
Humans
Male
Nerve Block*
Prostate*
Ultrasonography*

Figure

• 

  FIG. 1 Individual pain assessment, gray (PILP+NB), black (NB only). Data are shown as the percent or number of patients with each pain score according to visual analogue scale. PILP: perianal-intrarectal lidocaine-prilocaine, NB: nerve block.

• 

  FIG. 2 Comparison in the percent of patients with pain score of ≥3 or <3 between PILP+NB and NB only groups. Data are shown as the percent of patients and the comparison between the two is performed using the Pearson chi-square test. PILP: perianal-intrarectal lidocaine-prilocaine, NB: nerve block.

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