Comparison of Two Local Anesthesia Injection Methods During a Transrectal Ultrasonography-guided Prostate Biopsy

Abstract

PURPOSE: To compare the effectiveness of 2 injection methods of lidocaine during a transrectal ultrasound (TRUS)-guided prostate biopsy for pain control and complication rates. MATERIALS AND METHODS: We retrospectively evaluated patients who underwent a TRUS-guided prostate biopsy from March 2005 to March 2006. One hundred patients were categorized into two groups based on injection method. For group 1, 10 mL of 1% lidocaine was injected bilaterally at the junction of the seminal vesicle and prostate and for group 2, into Denonvilliers' fascia. Pain scores using a visual analog scale (VAS) as well as immediate and delayed complication rates were evaluated. RESULTS: The mean VAS score showed no significant differences between the groups (group 1, 3.4+/-1.78; group 2, 2.8+/-1.3; p = 0.062). The difference in delayed complication rates and incidence of hematuria, hemospermia, and blood via the rectum was not significant between groups. However, two patients in group 1 complained of symptoms immediately after local anesthesia; one of tinnitus and the other of mild dizziness. CONCLUSION: There were no significant differences between pain control and complication rates between the 2 lidocaine injection methods. However, injection into Denonvilliers' fascia is thought to have less potential risk.