Purpose: To compare patient reported pain during TRUS guided biopsies using intrarectal lidocaine gel versus lubricating gel.
Materials and methods: From May 2000 to May 2001, 360 men undergoing transrectal prostate biopsy were enrolled in this study. Patients were randomized into two groups. In group 1, 180 patients received 10 cc of 2% intrarectal lidocaine gel (Xylocaine 2% jelly, Astra Pharma Inc.) 5 to 10 minutes before the procedure and in group 2, 180 patients received 10 cc of lubricating gel. No other sedation or analgesia was given. Pain level immediately after the last biopsy was assessed using a 10-point linear visual analog pain scale.
Results: The median pain score during transrectal prostate biopsy was 2 (range 0 to 8) and 3 (range 1 to 10) in groups 1 and 2, respectively (p = 0.0001). Only minor complications occurred and complication rates were not significantly different between the groups.
Conclusion: Rectal administration of lidocaine gel is safe, simple and effective for reducing the pain level associated with transrectal prostate biopsy.