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Original Research

Transrektal prostat biyopsisinde anestezi seçimi: rektal lidokain jel instillasyonu ve lidokainle periprostatik sinir blokajı karşılaştırması


1 Akçaabat Haçkalı Baba Devlet Hastanesi Üroloji Kliniği Trabzon

2 Atatürk Üniversitesi Tıp Fakültesi Üroloji AD Erzurum

3 Bingöl Devlet Hastanesi Üroloji Kliniği Bingöl

4 Dicle Üniversitesi Tıp Fakültesi Üroloji AD Diyarbakır  


DOI :
New J Urol. 2014; 9 (13): 17-21

Abstract

Objectives: Prostate biopsy is the gold stan-dard for distinction of benign or malign patholo-gies of the prostate with certainty. However, pain is a serious problem during the procedure. The aim of this study was to compare the anesthetic techniques which may affect the degree of the pain during prostate biopsy, with two different methods guided with transrectal ultrasonog-raphy (TRUS). 

Materials and Methods: Prostate biopsy was performed for a total of 92 patients with high prostate-specific antigen (PSA) and a spicious findings with rectal examination. The pain of the patients was evaluated with visual analog pain scale (VAS). The process was made for the pati-ents with lateral decubitus position with 7 MHz transrectal ultrasound probe, 18 G automatic Tru-cut biopsy attachments. In one group, 5 mi-nutes before the TRUS probe insertion 10 mL of 2% lidocaine HCL gel was inserted into the rec-tum. For the other group, HCL 2% lidocaine gel before the procedure again, and for peri-prostatic nerve block 5 cc of lidocaine was injected separa-tely for the left and right lobe.

Results: None of the patients had described severe or excruciating pain. Significant differen-ces was observed with patient streated with rectal lidocain gel for VAS pain score compared with peri-prostatic nerve blockade after rectal lidocain gel (p <0.05).

Conclusions: TRUS guided prostate biopsy with rectal anest-hesia lidocaine gel was found to be well tolerated. Periprostatic nerve blockade after lidocain instillation process and enhances the comfort of the process and the patients, and only instillation of li-docaine gel was found to be less painful. Were commended perip-rostatic lidocaine injection in addition to lidocaine gel instillation before prostate biopsy.

Key Words: Prostate biopsy, rectal lidocaine gel anesthesia, pe-riprostatic nerve blockade.


Abstract

Objectives: Prostate biopsy is the gold stan-dard for distinction of benign or malign patholo-gies of the prostate with certainty. However, pain is a serious problem during the procedure. The aim of this study was to compare the anesthetic techniques which may affect the degree of the pain during prostate biopsy, with two different methods guided with transrectal ultrasonog-raphy (TRUS). 

Materials and Methods: Prostate biopsy was performed for a total of 92 patients with high prostate-specific antigen (PSA) and a spicious findings with rectal examination. The pain of the patients was evaluated with visual analog pain scale (VAS). The process was made for the pati-ents with lateral decubitus position with 7 MHz transrectal ultrasound probe, 18 G automatic Tru-cut biopsy attachments. In one group, 5 mi-nutes before the TRUS probe insertion 10 mL of 2% lidocaine HCL gel was inserted into the rec-tum. For the other group, HCL 2% lidocaine gel before the procedure again, and for peri-prostatic nerve block 5 cc of lidocaine was injected separa-tely for the left and right lobe.

Results: None of the patients had described severe or excruciating pain. Significant differen-ces was observed with patient streated with rectal lidocain gel for VAS pain score compared with peri-prostatic nerve blockade after rectal lidocain gel (p <0.05).

Conclusions: TRUS guided prostate biopsy with rectal anest-hesia lidocaine gel was found to be well tolerated. Periprostatic nerve blockade after lidocain instillation process and enhances the comfort of the process and the patients, and only instillation of li-docaine gel was found to be less painful. Were commended perip-rostatic lidocaine injection in addition to lidocaine gel instillation before prostate biopsy.

Key Words: Prostate biopsy, rectal lidocaine gel anesthesia, pe-riprostatic nerve blockade.

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