Use of an anesthetic cream before transrectal ultrasonography (TRUS)-guided needle biopsy of the prostate significantly reduces a patient’s level of pain during the procedure, according to a study published in the British Journal of Urology.

The prostate is a gland of the male reproductive system. It produces some of the fluid that transports sperm during ejaculation. After skin cancer, prostate cancer is the most common form of cancer diagnosed in men.

Prostate cancer is diagnosed by performing one or more biopsies of the prostate gland. The biopsy will determine whether a patient has benign prostatic hyperplasia (BPH), cancer, or another medical problem.

During a biopsy, a needle is used to remove several small pieces of prostate tissue through the rectum. These tissue samples are then examined under the microscope to determine whether cancer cells are present. During a TRUS-guided needle biopsy, a physician first inserts an ultrasound probe into the rectum in order to visualize the prostate and identify areas suspicious for cancer.

To test whether use of a topical anesthetic reduces pain during TRUS-guided needle biopsy, researchers in Italy conducted a randomized clinical trial among 200 patients. Before biopsy, the patients were assigned to receive either a lidocaine-prilocaine cream or a placebo cream. Cream was applied around the anus and in the rectum. Subjects were then asked to grade the pain when the TRUS probe was inserted and when the biopsy samples were taken.

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  • Patients treated with the lidocaine-prilocaine cream reported less pain than patients treated with the placebo cream. Lower levels of pain were reported both at the time of probe insertion and during biopsy.
  • Younger men (less than 67 years) benefited more from the lidocaine-prilocaine treatment than older men.
  • Adverse effects were minimal and did not differ between treatment groups.

The researchers conclude that use of a lidocaine-prilocaine cream significantly reduced pain levels during TRUS-guided needle biopsy of the prostate. The anesthetic cream provided a benefit during probe insertion as well as during biopsy.

Reference: Raber M, Scattoni V, Roscigno M et al. Perianal and Intrarectal Anaethesia for Transrectal Biopsy of the Prostate: A Prospective Randomized Study Comparing Lidocaine-prilocaine cream and placebo. British Journal of Urology. 2005;96:1264-1267.

Related News:Topical Paste Reduces Pain Associated with Prostate Biopsy (2/16/2005)

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