Perianal and intrarectal anaesthesia for transrectal biopsy of the prostate: a prospective randomized study comparing lidocaine‐prilocaine cream and placebo

Open Access
Publisher Website
Google Scholar
Abstract
OBJECTIVES To assess the effectiveness of perianal and intrarectal lidocaine‐prilocaine cream for prostate biopsy. PATIENTS AND METHODS In a prospective, randomized, double‐blind, placebo‐controlled study, 200 consecutive patients were randomized to receive 5 mL lidocaine‐prilocaine cream or 5 mL placebo peri‐anally and transrectally before transrectal ultrasonography (TRUS)‐guided prostate needle biopsy (mean number of cores, 12). The men were asked to grade the pain when the TRUS probe was inserted and during the biopsy procedure using a 10‐point linear visual analogue pain scale. RESULTS At probe insertion, men in the anaesthetic group reported a significantly lower mean pain level than men in the placebo group (0.3 vs 1.6, P < 0.001). Men who had anaesthetic also reported less pain during biopsy punctures (1.8 vs 3.2, P < 0.001). Stratifying results by age, younger men (P = 0.04) and biopsy (1.8 vs 4.0, P < 0.001) than older men (1.0 vs 1.1, P = 0.7 and 1.9 vs 2.4, P = 0.3, respectively). There were only minor complications, and these were not significantly different between the groups. CONCLUSION Topical anaesthesia with prilocaine‐lidocaine cream significantly reduced pain at transrectal probe insertion and during the biopsy procedure.