A Novel Pain Alternative for Patients with Anorectal Pathologies: The Comparison of Transperineal Prostatic Blockage Technique with Periprostatic Nerve Blockage and Rectal Gel Technique in Initial Transrectal Ultrasound-Guided Prostate Biopsy - A Prospective, Randomized Trial
Urologia Internationalis, cilt.97, sa.4, ss.416-420, 2016 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 97 Sayı: 4
- Basım Tarihi: 2016
- Doi Numarası: 10.1159/000448337
- Dergi Adı: Urologia Internationalis
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
- Sayfa Sayıları: ss.416-420
- Anahtar Kelimeler: Prostate biopsy, Transrectal ultrasound, Pain, Needle biopsy, Analgesia, Quality of life, Prostate cancer, Complication
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Introduction: The study aimed to compare the efficiency of periprostatic nerve blockage (PPNB) and intrarectal lidocaine gel (PPNB + gel) with a transperineal prostatic block (TPPB) technique during transrectal ultrasound-guided prostate biopsy (TRUS-PBx) in patients with anorectal pathologies. Materials and Methods: A total of 376 patients who underwent TRUS-PBx were randomized into 2 groups. Group-I (n = 198) received TPPB with 10 ml 2% prilocaine, and group-II (n = 178) received intrarectal administration of 10 ml 2% lidocaine gel followed by PPNB with 10 ml 2% prilocaine. A 10-point linear visual analogue scale (VAS) was used to assess the pain arising from probe insertion (VAS-1) and prostate sampling (VAS-2). Results: VAS-1 scores were significantly lower in group-I than group-II (1.7 ± 1.9 vs. 3.9 ± 1.5; p < 0.001). Combining local anesthesia produced superior pain control to TPPB during sampling (2.0 ± 1.2 vs. 2.5 ± 2.4; p = 0.015). Following subgroup analyses with reference to concomitant anorectal pathologies, VAS-1 scores were significantly lower in group-I than group-II (2.0 ± 1.8 vs. 5.5 ± 1.7; p < 0.001). VAS-2 scores were lower in group-II than group-I; however, the difference was not considered significant (2.4 ± 1.3 vs. 3.1 ± 2.8; p = 0.303). Conclusions: In all patients referred for TRUS-PBx, TPPB is a good alternative to PPNB + gel. TPPB can be particularly useful for patients with anorectal pathologies due to its improved pain reduction during probe insertion.