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According to a recent article published in the Journal of Urology, a topical paste that can be applied 30 minutes prior to biopsy reduces pain associated with prostate biopsies.

The prostate is a walnut-sized gland that is located between the bladder and rectum. It is responsible for forming a component of semen. Approximately 230,000 new cases of prostate cancer are diagnosed annually in the United States alone. However, non-cancerous (benign) conditions are also a common medical issue in men, particularly older men. In order to determine whether a patient had prostate cancer or a benign condition, a prostate biopsy must be conducted. A prostate biopsy consists of the removal of tissue samples in the prostate. 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. Unfortunately, the process of a prostate biopsy is associated with mild to severe pain and researchers have been evaluating ways in which to reduce this pain, particularly as men often have to undergo several, periodic prostate biopsies.

Researchers recently conducted a clinical trial to evaluate a topical pain reliever, 0.2% glyceryl trinitrate (GTN) paste and its effects on pain associated with prostate biopsies. This trial included 134 patients who were to undergo their first biopsy. Patients either received topical GTN 30 minutes prior to the biopsy, or placebo (inactive substitute). Participants were then asked to fill out a pain questionnaire, based on a 10-point pain scale following the procedure. Patients who had received GTN had a significant reduction in pain (3.7 on the scale), compared to those who had received placebo (almost 5 on the scale). Side effects of GTN included 10% of patients reporting a headache.

The researchers concluded that topical GTN appear to reduce pain associated with prostate biopsies. They suggest that patients should be offered the option of GTN prior to undergoing the procedure. Patients who are to undergo a prostate biopsy may wish to speak with their physician regarding their individual risks and benefits of treatment with GTN or other pain relievers prior to the procedure.

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Reference: Rochester M, Le Monnier K, Brewster S. A double-blind, randomized, controlled trial of topical glyceryl trinitrate for transrectal ultrasound guided prostate biopsy. Journal of Urology. 2005;173:418-420.

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