Prospective randomized trial to evaluate effectiveness of periprostatic nerve block in prostatic biopsy

OBJECTIVES: The objective of the study was to evaluate the efficacy of local anesthetic infiltration, in decreasing the discomfort experienced by patients undergoing trans-rectal ultrasound (TRUS) guided biopsy of prostate. MATERIALS AND METHODS: Between January 2002 and February 2003, we investigated consecutively, asymptomatic men, suspected of having prostatic cancer. About 39 patients were randomized to receive 10 ml of 2% Lidocaine periprostatic block + intrarectal Lidocaine gel (group 1 = 20), or intarectal Lidocaine gel only (group 2 = 19) during prostatic biopsy. Immediately following the TRUS-guided biopsy, patients were asked to grade the pain they experienced using the 11-point visual analogue score (VAS). RESULTS: The mean pain score in the patients of group 1 were significantly lower than the patients of group 2 (P<0.001), suggesting that periprostatic block produced a significant reduction in the perceived pain. CONCLUSIONS: Local anesthetic infiltration by TRUS-guided injection of Lidocaine is effective for decreasing pain associated with prostatic biopsy.