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Pain scores and local anesthesia for transrectal ultrasound-guided prostate biopsy in patients with anorectal pathologies.

Author(s): Demir E, Kilicer M, Bedir S, Kilciler G, Erten K, Ozgok Y

Affiliation(s): Department of Urology, Gulhane Military Medical Faculty, Etlik/Ankara, Turkey. demir74@superonline.com

Publication date & source: 2007-11, J Endourol., 21(11):1367-9.

Publication type: Evaluation Studies; Randomized Controlled Trial

PURPOSE: The aim of the present randomized study was to evaluate the efficacy of lidocaine gel compared with dimethylsulfoxide (DMSO) with lidocaine for transrectal ultrasonography (TRUS)-guided prostate biopsy in patients with anorectal pathologies. PATIENTS AND METHODS: Sixty-two patients were randomly divided into two equal groups. Group 1 was given 10 mL of 2% lidocaine gel intrarectally 10 minutes before the biopsy. Group 2 was given 10 mL of intrarectal 40% DMSO with an amount of lidocaine equal to that in the lidocaine gel 10 minutes before the procedure. The degree of pain was rated by patients using a 10-point visual analog scale. RESULTS: The pain scores for probe insertion were significantly lower for group 2 (3.15 +/- 1.41) than for group 1 (4.58 +/- 160) (P = 0.01). No significant differences were found between the pain scores of the two groups for biopsy-needle insertion (P = 0.62). CONCLUSIONS: Dimethylsulfoxide with lidocaine instilled into the rectum is a simple, safe, rapid-acting, and effective method of anesthesia delivery before TRUS-guided prostate biopsy in patients with anorectal pathologies.

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