Journal of Korean Society of Ultrasound in Medicine 2010;29(3): 165-169.
Comparison of Two Local Anesthesia Injection Methods During a Transrectal Ultrasonography-guided Prostate Biopsy.
Song Ee Baek, Young Taik Oh, Jang Hwan Kim, Koon Ho Rha, Sung Joon Hong, Seung Choul Yang
1Department of Radiology and Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea.
2Department of Urology, Yonsei University College of Medicine, Seoul, Korea.
  Published online: September 1, 2010.
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.
Keywords: Prostate; Biopsy; Ultrasonography; Local anesthesia; Nerve block
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