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The effect of heated lidocaine gel on pain reduction during transrectal ultrasound-guided prostate biopsy: a randomized-controlled study

  • Urology - Original Paper
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Abstract

Purpose

To determine whether intrarectal local anesthesia (IRLA) with heated lidocaine gel provides pain reduction during transrectal ultrasound (TRUS)-guided prostate biopsy.

Methods

We conducted a randomized-controlled study with 153 participants who underwent TRUS-guided, systematic 12-core prostate biopsy from May 2018 to June 2019. These participants were divided into three test groups. Before prostate biopsy, group A (51 patients) received no local anesthesia, group B (51 patients) received IRLA with 20 mL 2% lidocaine gel stored at room temperature, and group C (51 patients) received IRLA with heated (40 ℃) 20 mL 2% lidocaine gel. Pain was assessed using the 0–10 visual analogue scale (VAS) at three time points: VAS-1: during probe insertion, VAS-2: during biopsy, VAS-3: 30 min after the procedure. Complications during and after the procedure were evaluated.

Results

The mean VAS-2 score was significantly lower in group C compared to groups A and B (A, 4.6; B, 4.2; and C, 3.2; p < 0.05). There was no significant difference among the three groups in mean VAS-1 and VAS-3 scores. No significant difference was detected in incidence of complications between the three groups. No allergic reactions to lidocaine gel were observed.

Conclusion

IRLA with heated lidocaine gel provides more effective pain control during TRUS-guided prostate biopsy than does conventional IRLA and no local anesthesia, without an increase of complications.

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Data availability

Data for this study are available on reasonable request from the authors.

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Acknowledgements

The authors wish to acknowledge the financial support of The Catholic University of Korea Uijeongbu St. Mary’s Hospital Clinical Research Laboratory Foundation made in the program year of 2018.

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Authors and Affiliations

  1. Department of Urology, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea

    Sang Rak Bae, Chang Hee Han & Bong Hee Park

  2. Department of Radiology, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, Republic of Korea

    Jung Im Kim

  3. Department of Nursing, Uijeongbu St. Mary’s Hospital, The Catholic University of Korea, Seoul, Republic of Korea

    Hee Nam Moon

  4. Department of Urology, Armed Forces Hongcheon Hospital, Ministry of National Defense, Seoul, Republic of Korea

    Joon Se Jung

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  1. Joon Se Jung
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Correspondence to Bong Hee Park.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Jung, J.S., Moon, H.N., Kim, J.I. et al. The effect of heated lidocaine gel on pain reduction during transrectal ultrasound-guided prostate biopsy: a randomized-controlled study. Int Urol Nephrol 53, 2437–2443 (2021). https://doi.org/10.1007/s11255-021-03006-2

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