Abstract
BackgroundProstate biopsy is a painful procedure. However, over the years, varied opinions exist among urologists about the methods of achieving optimal pain relief for the procedure. The purpose of this study was to compare the tolerability of administration and the efficacy of intra-rectal lidocaine gel with peri-prostatic nerve block for this procedure.MethodsFrom June 2016 to June 2017, 110 patients who met the study criteria were randomized to receive either intra-rectal lidocaine gel (Group 1) or an apical peri-prostatic nerve block (Group 2) for prostate biopsy. Their level of pain perception during the anaesthesia administration and the prostate biopsy was assessed using the Numeric Rating Scale. Other biopsy-related complications and patient satisfaction were also evaluated. Grouped data were compared using student t test and Chi-square with p < 0.05 considered significant.ResultsThe pain score during the administration of anaesthesia was 1.6 ± 1.9 and 3.7 ± 2.1 for the intra-rectal lidocaine gel and peri-prostatic nerve block groups, respectively (p = 0.001). However, during the prostate biopsy, the pain score was 6.8 ± 2.2 and 2.9 ± 1.9 for the intra-rectal lidocaine gel and peri-prostatic nerve block groups, respectively (p = 0.001). There was a significantly lower rate of satisfaction (45.3% versus 86.8%, p = 0.001) in the lidocaine gel group.ConclusionsAlthough intra-rectal lidocaine gel administration is better tolerated by patients, a peri-prostatic nerve block is more effective and provides better patient satisfaction than intra-rectal lidocaine gel when used as anaesthesia for prostate biopsy.
Highlights
IntroductionThe purpose of this study was to compare the tolerability of administration and the efficacy of intra-rectal lidocaine gel with peri-prostatic nerve block for this procedure
This study aimed to compare the tolerability of administration and efficacy of intra-rectal lidocaine gel with peri-prostatic nerve block as techniques of anaesthesia for prostate biopsy
The age, prostate-specific antigen and prostate volume were similar between the groups (p > 0.05) (Table 1)
Summary
The purpose of this study was to compare the tolerability of administration and the efficacy of intra-rectal lidocaine gel with peri-prostatic nerve block for this procedure. Patients experience varying degrees of pain during prostate biopsy. This occurs as a result of the introduction and movement of the ultrasound probe in the rectum, the injection of local anaesthetic as well as due to the penetration of the biopsy needle into the prostate capsule [4,5,6,7]. Tolani et al Afr J Urol (2020) 26:26 levels of pain relief are felt by patients receiving local, regional or general anaesthesia for prostate biopsy [5, 6, 8, 9]. There is a great recognition of the use of local anaesthesia for the procedure because of its ease of administration, cost and relatively fewer safety concerns compared to regional or systemic anaesthesia [7, 10]
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