Efficacy of periprostatic nerve blockade during ultrasound-guided transrectal 10-core biopsy of the prostate

PURPOSE: We examined the efficacy and safety of periprostatic nerve blockade during transrectal ultrasound guided prostate biopsy. MATERIALS AND METHODS: Transrectal ultrasound guided 10 core biopsy of the prostate was performed in 116 consecutive men. From March 2002 to July 2003, 58 men underwent biopsy of the prostate without local anesthesia (control group). From August 2003 to March 2004, 58 men received periprostatic nerve blockade before prostate biopsies (anesthesia group). A 4-ml dose of 1% lidocaine was injected at 2 or 3 locations on each side of the prostate via a 23 gauge needle. Pain during biopsy was questioned using a 5-point Face scale and complications were also recorded. RESULTS: The average pain score during biopsy was 1.9 in the anesthesia group versus 3.1 in the control group (p<0.001). In the anesthesia group 20.7% of patients had a pain score 3 or greater than 3 versus 69% in the control group. The complication rate showed no significant difference between the two groups. CONCLUSIONS: Periprostatic nerve blockade is a safe and effective method of anesthesia for transrectal prostate biopsy.