Abstract

INTRODUCTION

This study aims to compare the spray form of lidocaine (LS), which is a local anesthetic agent, to its other forms including lidocaine cream (LC) and lidocaine gel (LG) by administering a visual analogue scale (VAS) to obtain post Transrectal ultrasound guided biopsy (TRUSG-Bx) pain scores.

METHODS

Patients who presented to our clinic with lower urinary tract symptoms and/or had PSA levels requested for assessment purposes, had PSA levels exceeding 2.5 and/or suspicious findings in their rectal examination between 2014 May-2015 February were included in the study. The records of 175 patients were randomized to 4 groups. Group 1: Periprostatic nerve block (PPNB), Group 2: PPNB accompanied by 5g 5% LC administered to the perianal mucosa 5 min before the procedure, Group 3: PPNB accompanied by perianal-intrarectal 5 ml 2% LG 10 min before the procedure, Group 4: PPNB accompanied by 5 doses of LS (10mg/100ml) administered perianally 2 min before the procedure. The pain felt by the patients after 30 min from the operation was evaluated using a VAS.

RESULTS

Mean VAS scores of the groups were calculated as 3,34 ± 1.3 for Group 1, 2,81 ± 1.9 for Group 2, 3,52 ± 1.9 for Group 3, and 2,56 ± 1.2 for Group 4. LS was found to reduce VAS scores more than the other three methods with statistical significance (p=0.025<0.05)

DISCUSSION AND CONCLUSION

LS is a non-invasive, safe, and affordable option. Adding LS to PPNB decreases post TRUSG-Bx pain more significantly than the other forms.