Comparison of periprostatic local anesthesia and topical anesthesia of rectal mucous membrane for trans-rectal ultrasound-guided prostate biopsy

doi:10.3877/cma.j.issn.1674-3253.2020.01.002

Abstract

Abstract:

Objective

To compare the efficacy and safety between periprostatic local anesthesia and topical anesthesia of rectal mucous membrane for trans-rectal ultrasound-guided prostate biopsy.

Methods

Patients with suspected prostate cancer undergoing prostate biopsy were randomly divided into two groups prospectively. Local infiltration anesthesia with lidocaine was performed in the experimental group under the guidance of color Doppler ultrasound in the angle between the prostate base and the seminal vesicles around the neurovascular bundle on each side with lidocaine; while the control group was treated with topical anesthesia of rectal mucous membrane. We collected baseline characteristics, VAS, residual urine volume measured twice: before biopsy, the first micturition right after biopsy. Associated complications including positive rate of biopsy and Gleason score were also recorded.

Results

A total of 66 patients were included in this study. The pain score of experimental group was lower than the control group. Experimental group had lower rate of urinary retention and catheterization. Both groups had similar positive rate of biopsy, residual urine volume, Gleason score and rate of fever.

Conclusions

Comparing with topical anesthesia of rectal mucous membrane, periprostatic local anesthesia relieved more pain associated with trans-rectal ultrasound-guided prostate biopsy. It was more effective and safer but it should be guided by experienced ultra-sound physician.

Key words: Local anesthesia, Topical anesthesia, Ultrasound-guided, Prostate biopsy, Prospective, randomized controlled trial

Sijie Lin, Jieying Wu, Minhua Lu, Xinghao Li, Youqiang Fang. Comparison of periprostatic local anesthesia and topical anesthesia of rectal mucous membrane for trans-rectal ultrasound-guided prostate biopsy[J]. Chinese Journal of Endourology(Electronic Edition), 2020, 14(01): 4-7.

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References 28

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研究结果	例数	年龄（岁，±s）	t-PSA[μg/L，M(Q)]	f-PSA[μg/L，M(Q)]	前列腺体积[ml，M(Q)]	IPSS[分，M(Q)]	针数[针，M(Q)]	穿刺前插尿管（例）	尿WBC高（例）
实验组	33	67±8	13.31（14.07）	2.19（2.52）	63（60）	14（9.5）	12（1）	11	6
对照组	33	68±9	13.74（13.60）	2.04（3.06）	63（54）	12（8.5）	12（1）	11	10
统计值	?	t=-0.517	Z=-0.058	Z=-0.571	Z=-0.404	Z=-0.026	Z=-0.793	χ²=0	χ²=1.320
P值	?	0.607	0.954	0.568	0.686	0.979	0.428	1.000	0.251

研究结果	例数	年龄（岁，±s）	t-PSA[μg/L，M(Q)]	f-PSA[μg/L，M(Q)]	前列腺体积[ml，M(Q)]	IPSS[分，M(Q)]	针数[针，M(Q)]	穿刺前插尿管（例）	尿WBC高（例）
实验组	33	67±8	13.31（14.07）	2.19（2.52）	63（60）	14（9.5）	12（1）	11	6
对照组	33	68±9	13.74（13.60）	2.04（3.06）	63（54）	12（8.5）	12（1）	11	10
统计值	?	t=-0.517	Z=-0.058	Z=-0.571	Z=-0.404	Z=-0.026	Z=-0.793	χ²=0	χ²=1.320
P值	?	0.607	0.954	0.568	0.686	0.979	0.428	1.000	0.251

组别	例数	VAS（分）	穿刺前残余尿（ml）	穿刺后残余尿（ml）	穿刺前后残余尿差值（ml）
实验组	33	3（1）	26（39）	83（233）	61（164）
对照组	33	6（2）	32（40）	126（105）	96（92）
Z值	?	-6.947	-0.963	-0.435	-0.434
P值	?	<0.001	-0.335	-0.664	-0.664

组别	例数	VAS（分）	穿刺前残余尿（ml）	穿刺后残余尿（ml）	穿刺前后残余尿差值（ml）
实验组	33	3（1）	26（39）	83（233）	61（164）
对照组	33	6（2）	32（40）	126（105）	96（92）
Z值	?	-6.947	-0.963	-0.435	-0.434
P值	?	<0.001	-0.335	-0.664	-0.664

组别	例数	穿刺阳性（例）	Gleason评分（分，±s）	肉眼血尿（例）	肉眼血便（例）	尿潴留（例）	插尿管（例）	发热（例）
实验组	33	9	7.7±0.9	18	9	13	9	0
对照组	33	8	7.4±1.4	18	9	16	12	0
统计值	?	χ²=1.320	t=0.521	χ²=0	χ²=0	χ²=0.554	χ²=0.629	-
P值	?	0.778	0.610	1.000	1.000	0.457	0.428	1.000

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