psd-502 and Urinary-Tract-Infections

The aim of this paper was to optimize pain control during transrectal ultrasound (TRUS) guided prostate biopsy, the efficacy and safety of three different analgesic techniques were compared.. Two hundred and forty patients were prospectively randomized into 3 groups before TRUS guided prostate biopsy. Group A received combined periprostatic nerve block (PPNB) and perianal-intrarectal lidocaine-prilocaine (PILP) cream; group B: PILP cream; group C: PPNB. Pain was evaluated using 10-point Visual Analog Scale (VAS).. VAS during TRUS was lower in groups A and B vs. C (mean 1.3,1.4 vs. 5.1, P<0.001); VAS for PPNB was lower in group A and group B vs. C (mean 1.1,1.3 vs. 3.5, P<0.001). VAS for sampling wase lower in group A as compared to B and C (mean 0.6, 3.5 and 1.4, P<0.001). VAS on stratified analysis was significantly lower in groupA vs. B and C in patients <60 years, prostate >50 cc and those with lower anorectal compliance (P<0.001). The overall complication rate was similar in all three groups.. The combination of PILP and PPNB provides better analgesia, especially in patients <60 years, prostate volume >50 cc and lower anorectal compliance as compared to two modalities used alone during the sampling part of TRUS guided prostate biopsy with no increase in the complication rate.

Topics: Administration, Rectal; Aged; Analgesia; Anesthetics, Combined; Anesthetics, Local; Biopsy, Needle; Drug Therapy, Combination; Hemorrhage; Humans; Injections; Lidocaine; Lidocaine, Prilocaine Drug Combination; Male; Middle Aged; Nerve Block; Ointments; Pain; Pain Management; Pain Measurement; Prilocaine; Prospective Studies; Prostate; Ultrasonography, Interventional; Urinary Tract Infections