A single injection of lidocaine into the apex of the prostate works as well as bilateral basal injections in easing the pain of ultrasound-guided prostate needle biopsy, according to researchers in Turkey.
Of 117 men undergoing the procedure, 60 received two 5-mL injections of lidocaine just lateral to the junction between the base of the prostate and the seminal vesicles on both sides and 57 received a single 5-mL injection at the apex of the prostate. Following the procedure, patients evaluated their pain using a numeric rating scale (NRS) where 0 indicated no pain and 10 indicated the greatest pain imaginable.
Both techniques were effective for pain control, with significantly better results reported in the apical injection group, the researchers reported in Urology (2009;73:23-26). The mean NRS score was 2.01 in the apical injection group compared with 2.46 in the bilateral injection group.
“The main advantage of the single apical injection technique is its ease of use and the requirement for one-half the amount of local anesthetic agent,” the authors concluded.