Poster Session 2: BPH and prostate biopsy| Volume 8, ISSUE 8, P616, September 2009

S29 Transrectal ultrasound-guided prostate biopsy, periprostatic local anesthesia and pain tolerance

      Introduction and Objectives

      We have evaluated objectively pain tolerance in transrectal ultrasound-guided prostate biopsy (TRUS) using local periprostatic anesthesia applied intrarectally, compared to the conventional method.

      Material and Methods

      From November 2008 to May 2009, 90 patients underwent transrectal ultrasound-guided prostate biopsy at Departmentof Urology, Clinical Center University Sarajevo. 90 patients whofulfilled the inclusion criteria were randomized into 3 groups of 30 patients each. Group 1 received periprostatic local anesthesia with 2% lidocaine, group 2 recived Voltaren supp placed in rectum an hour before biopsy while group 3 received no local anesthesia. Pain scaleresponses were analyzed for each aspect of the biopsy procedure with avisual analog scale of 0-none to 10-maximal.


      There was no difference between the 3 groups in pain scoresduring digital rectal examination, intrarectal injection and probe insertion. The mean pain scores during needle insertion in group 1 receiving periprostatic nerve block and in group 2 receiving Voltaren supp. were 3.10±2.32 and 5.15±2.01. In group 3 (no local anesthesia) were 6.06±2.95, respectively, and were found to be significantlydifferent (p <0.001), but morbidity after the biopsy was notstatistically different between all 3 groups.


      TRUS-guided prostate biopsy is a traumatic and painful experience, but the periprostatic blockage use is clearly associated with more tolerance and patient comfort during the exam. It is an easy, safe, acceptable and reproducible technique and should be considered for all patients undergoing TRUS biopsy regardless of age or number of biopsies.