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Introduction: The study aimed to compare the efficiency of periprostatic nerve blockage (PPNB) and intrarectal lidocaine gel (PPNB + gel) with a transperineal prostatic block (TPPB) technique during transrectal ultrasound-guided prostate biopsy (TRUS-PBx) in patients with anorectal pathologies., Materials and Methods: A total of 376 patients who underwent TRUS-PBx were randomized into 2 groups. Group-I (n = 198) received TPPB with 10 ml 2% prilocaine, and group-II (n = 178) received intrarectal administration of 10 ml 2% lidocaine gel followed by PPNB with 10 ml 2% prilocaine. A 10-point linear visual analogue scale (VAS) was used to assess the pain arising from probe insertion (VAS-1) and prostate sampling (VAS-2)., Results: VAS-1 scores were significantly lower in group-I than group-II (1.7 ± 1.9 vs. 3.9 ± 1.5; p < 0.001). Combining local anesthesia produced superior pain control to TPPB during sampling (2.0 ± 1.2 vs. 2.5 ± 2.4; p = 0.015). Following subgroup analyses with reference to concomitant anorectal pathologies, VAS-1 scores were significantly lower in group-I than group-II (2.0 ± 1.8 vs. 5.5 ± 1.7; p < 0.001). VAS-2 scores were lower in group-II than group-I; however, the difference was not considered significant (2.4 ± 1.3 vs. 3.1 ± 2.8; p = 0.303)., Conclusions: In all patients referred for TRUS-PBx, TPPB is a good alternative to PPNB + gel. TPPB can be particularly useful for patients with anorectal pathologies due to its improved pain reduction during probe insertion., (© 2016 S. Karger AG, Basel.)

Objective: In this study we evaluated the effects of prior history of prostate biopsy on pain scores of patients who underwent transrectal ultrasound-guided prostate biopsy (TRUS-PBx). Materials and Methods: Between October 2014 and April 2015, 198 patients who underwent primary or repeat prostate biopsy with abnormal digital rectal examination findings, high prostate specific antigen (PSA) levels (≥2.5 ng/mL) or suspicious lesions for prostate cancer in prior biopsies were included in the study. Before the biopsy procedure, all patients underwent transperineal periprostatic block with 10 mL of 2% prilocaine. A 10-point linear visual analogue scale (VAS) was used to assess the pain arising from probe insertion (VAS-1) and prostate sampling (VAS-2). Patients were separated into two groups: Patients without a prior prostate biopsy were enrolled in group 1 and the patients with history of prostate biopsy were enrolled in group 2. Results: The mean age of the patients was 64±7.3 years, and the mean PSA value was 12.5±18.3 ng/dL. Prostate cancer detection rate was 22.7%. There were 173 patients in group 1 and 25 patients in group 2. VAS-1 scores were comparable between the groups (1.7±2.0 vs. 1.7±1.8; p=0.957). VAS-2 score was lower in group 2 than group 1's (2.0±2.3 vs. 2.6±2.4); however, the difference was not statistically significant (p=0.290). Conclusion: Prior prostate biopsy experience does not affect the pain scores during TRUS-PBx. [ABSTRACT FROM AUTHOR]

Objectives: In this study, we assessed the relationship between pain scores and the pathology results of patients who underwent transrectal ultrasound-guided prostate biopsy (TRUS-PBx). Materials and Methods: A total of 198 patients who underwent prostate biopsy between October 2014 and April 2015 due to abnormal digital rectal examination findings and/or high prostatespecific antigen (PSA) levels (=2.5 ng/dL) were included in this study. Before the biopsy procedure, all patients underwent finger-guided transperineal periprostatic block with 10 mL of 2% prilocaine. A 10-point linear visual analogue scale (VAS) was used to assess the pain arising from probe insertion (VAS-1) and prostate sampling (VAS-2). After receiving the pathology results, the patients were grouped according to the presence of prostate cancer: Group 1: patients without prostate cancer and Group 2: patients with prostate cancer. Results: The mean age of the patients was 64±7.3 (43-83) years, and the mean PSA value was 12.5±18.3 (0.6-142) ng/dL. Prostate cancer detection rate was 22.7%. The mean VAS-1 score in Group 1 and group 2 was 1.6±1.8 and 2.0±2.5, respectively (p=0.209). The mean VAS-2 score in Group 1 and Group 2 was 2.5±2.4 and 2.6±2.6, respectively (p=0,725). Conclusion: The pain felt during TRUS-PBx is not related with the presence of prostate cancer on biopsy pathology. [ABSTRACT FROM AUTHOR]