Urogenit Tract Infect.  2016 Dec;11(3):97-102. 10.14777/uti.2016.11.3.97.

The Effect of Intrarectal Lidocaine Gel Instillation before Transrectal Ultrasound Guided Prostate Biopsy

• Kim YS
• Kim SK
• Choi K
• Cho IC
• Min SK

• KMID: 2366145
• DOI: http://doi.org/10.14777/uti.2016.11.3.97

Abstract

PURPOSE
To compare pain induced by a transrectal ultrasound (TRUS)-guided prostate biopsy in men between using local lidocaine gel or plain lubricant.
MATERIALS AND METHODS
Between January and October of 2014, a total of 63 consecutive patients undergoing TRUS-guided prostate biopsy for elevated prostate-specific antigen (PSA) levels and/or a suspicious digital rectal examination were randomized to two groups: lidocaine group and control group. In the lidocaine group (n=31), patients received 20 ml of 2% lidocaine gel and betadine solution soaked gauze was administered via a transrectal route 10 minutes before the procedure. In the control group (n=32), 20 ml plain lubricant and betadine solution soaked gauze was administrated under the same condition. After the biopsy procedure, patients were asked to rate their pain perception on a 10-point visual analog scale (VAS) score.
RESULTS
There was no statistically significant difference with the mean patient age, PSA, prostate volume, biopsy duration time between lidocaine group and control group. The mean pain score and number of patients with VAS ≥5 in the lidocaine group (4.14±2.0, 10) were significantly lower than those in the control group (5.78±2.3, 19). In younger men (≤65 years), pain was reported significantly less in the lidocaine group than in the control group. Complication rates were not different between the two groups.
CONCLUSIONS
Intrarectal lidocaine gel is a simple, safe, and efficacious for reducing pain and discomfort during the TRUS-guided prostate biopsy procedure. It appears to have an enhanced effect, especially in younger than in older men.

Keyword

Biopsy; Anesthetics, local; Lidocaine; Pain; Prostate

MeSH Terms

Anesthetics, Local
Biopsy*
Digital Rectal Examination
Humans
Lidocaine*
Male
Pain Perception
Povidone-Iodine
Prostate*
Prostate-Specific Antigen
Ultrasonography*
Visual Analog Scale
Anesthetics, Local
Lidocaine
Povidone-Iodine
Prostate-Specific Antigen

Figure

• 

  Fig. 1. Percent distribution of pain perception in the two groups.

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  Fig. 2. Mean pain level in the lidocaine gel anesthetic group and control group in younger and older men during prostate biopsy. VAS: visual analog scale.

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