Efficacy of intrarectal lidocaine hydrochloride gel for pain control in patients undergoing transrectal prostate biopsy

OBJECTIVE: To determine the efficacy of intrarectal lidocaine hydrochloride gel in reducing pain in patients undergoing transrectal prostate biopsy. MATERIALS AND METHODS: During the period from June to Noviber 2002, 72 patients undergoing transrectal prostate biopsy at an outpatient service were prospectively randomized. Patients were divided into 2 groups. In group 1, 20 mL of 2% lidocaine gel were administered by intrarectal route 15 minutes before biopsy. In group 2 (placebo), 20 mL of ultrasound gel were administered under the same conditions. At the end of the procedure, patients were asked to classify the discomfort degree observed during the procedure through a verbal pain scale. Statistical analysis was performed through qui-square test. RESULTS: The majority of patients in both groups presented slight pain on the examination, and 26 patients (76.4%) from group 1, and 26 (68.3%) patients from group 2 reported slight pain or no pain at all (p > 0.05). Moderate or intense pain was felt by 23.4% of patients in group 1 and 31.5% of patients in group 2 (p > 0.05). CONCLUSIONS: We concluded that lidocaine probably exerts a minimal effect on patients’ tolerance to pain on transrectal prostate biopsy.