MP53-18 COMBINED PERIANAL-INTRARECTAL TETRACAINE CREAM AND TOTALLY PERIPROSTATIC NERVE BLOCK IMPROVES PAIN CONTROL DURING TRANSRECTAL ULTRASOUND GUIDED BIOPSY OF THE PROSTATE

Abstract

You have accessJournal of UrologyProstate Cancer: Detection & Screening II1 Apr 2014MP53-18 COMBINED PERIANAL-INTRARECTAL TETRACAINE CREAM AND TOTALLY PERIPROSTATIC NERVE BLOCK IMPROVES PAIN CONTROL DURING TRANSRECTAL ULTRASOUND GUIDED BIOPSY OF THE PROSTATE Pengchao Li, Hongqing Cui, Zengjun Wang, Changjun Yin, Lixin Hua, and Ninghong Song Pengchao LiPengchao Li More articles by this author , Hongqing CuiHongqing Cui More articles by this author , Zengjun WangZengjun Wang More articles by this author , Changjun YinChangjun Yin More articles by this author , Lixin HuaLixin Hua More articles by this author , and Ninghong SongNinghong Song More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1649AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail Introduction and Objectives Periprostatic nerve block (PPNB) is recommended as the standard method to alleviated pain during transrectal prostate biopsy (TRPB). However, the process of PPNB may be painful and the effect of PPNB may be insufficient for certain patients. We compared pain control results between totally PPNB alone and PPNB combined with topical perianal-intrarectal tetracaine cream during TRPB. Methods One hundred and eighty cases of TRUS-guided prostate biopsy in our department from July 2012 to June 2013 were divided into three groups: 80 patients (Group A) without local anesthesia, 50 patients (Group B) underwent totally PPNB, 50 patients (Group C) underwent combined perianal-intrarectal tetracaine cream and totally PPNB. Perianal-intrarectal tetracaine cream was administered 30 minutes before biopsy. Totally PPNB was performed by injecting lidocaine around seminal vesicle, in the junction between prostate and bladder neck, and along the bilateral neurovascular bundle. A 22 G puncture needle was placed through a transrectal ultrasound biopsy guide. Thirteen-core biopsies were performed. Following biopsy, we accessed the pain by Visual Analog Scale (VAS) assessment. The VAS score included different period when inserting ultrasound probe (VAS1), injecting lidocaine (VAS2), harvesting specimens (VAS3) and 30 minutes after biopsy (VAS4). Results The incidences of infection was comparable between 3 groups. The VAS1 of group C was lower than group B (P < 0.01), group A (P < 0.01). No significant difference was found between the VAS1 of group A and group B (P = 0.825). The VAS2 of group C was lower than group B (P < 0.01) when performing totally PPNB. The VAS3 of group C was lower than group B (P < 0.01), and VAS3 of group B was lower than group A (P < 0.01). The VAS4 of group C was lower than group B (P < 0.01), and VAS4 of group B was lower than group A (P < 0.01). Fig1 Injecting lidocaine around seminal vesicle, more liquid signal can be seen around seminal vesicle after injecting lidocaine. Conclusions Combined perianal-intrarectal tetracaine cream and totally PPNB provided better pain relief than totally PPNB alone during TRPB. Preparatory administration of perianal-intrarectal tetracaine cream alleviated the pain of PPNB. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e595-e596 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Pengchao Li More articles by this author Hongqing Cui More articles by this author Zengjun Wang More articles by this author Changjun Yin More articles by this author Lixin Hua More articles by this author Ninghong Song More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...