Objective: To compare the analgesic efficacy of rectal administration of Lidocaïne gel with Lidocaïne periprostatic infiltration prior to transrectal ultrasound-guided prostate biopsies.
Material and methods: Between July 2002 and July 2003, candidates to prostate biopsies were randomised into two groups. In group 1, 15 ml 2% Lidocaïne gel was administered intra-rectally 10 minutes prior to biopsies and patients included in group 2 received 10 ml of 1% Lidocaïne in two périprostatique equivalent injections, 4 minutes prior to prostate biopsies. Pain was assessed with a Visual Analog Scale, during anaesthesia (VAS 1), during the biopsies procedure (VAS 2) and 30 minutes after them (VAS 3).
Results: 308 patients were included in this trial with 156 patients in group 1 and 152 in group 2. Group 1 experienced statistically less pain for VAS 1 (0.1 versus 1.4, p < 0.0001) and VAS 3 (0.8 versus 1.4, p < 0.001) but no significative difference could be demonstrated for VAS 2 (1.8 versus 2.0). No major complication was noted.
Conclusion: Rectal administration of Lidocaïne gel and infiltration of Lidocaïne lead to a comparable level of anaesthesia during prostatic biopsies procedure. However, the Lidocaïne gel, being both safe and simple, tends to maintain a better comfort of the patient 30 minutes after the end of the biopsies.