Bilateral Fine-Needle Administered Local Anaesthetic Nerve Block for Pain Control during TRUS-Guided Multi-Core Prostate Biopsy: A Prospective Randomised Trial

Introduction: Transrectal multi-core biopsies of the prostate can cause substantial discomfort with the need for high dose systemic analgesics. In a prospective randomised trial we investigated the efficacy of fine-needle administered local anaesthesia for bilateral prostatic nerve block prior to transrectal ultrasound (TRUS) guided prostate biopsy. Materials and Methods: One hundred and eight men suspected of having cancer of the prostate were randomised to receive TRUS-guided bilateral prostate nerve block prior to biopsy or not, when having no history of previous prostate biopsies (groups I and II, n=68). In group III ( n=40) all patients with history of previous biopsies exclusively received local anaesthesia injection. Patients routinely underwent a 10-core biopsy regimen. For repeat biopsy 12 cores were taken. The consented patients documented pain on a visual analogue pain score. Results: In the randomised groups I and II average pain score was 1.85 with versus 3.29 without periprostatic nerve block ( p