Periprostatic and Iliohypogastric Nerve Block for Pain in Transrectal Prostate Biopsy

Objectives

We aimed to investigate the effect of Periprostatic Nerve Block (PNB) and Iliohypogastric Nerve Block (INB) on pain control during transrectal ultrasound-guided prostate biopsy.

Methods

In total, 90 patients who underwent transrectal ultrasound-guided prostate biopsy due to suspected prostate cancer were randomized into three groups (30 patients each). Group 1 received intrarectal prilocaine–lidocaine cream (control group). Group 2 received PNB and intrarectal prilocaine–lidocaine cream. Group 3 received INB and intrarectal prilocaine-lidocaine cream. Visual Analog Scale (VAS), a subjective scale, and Electromyography (EMG), an objective scale, were used to evaluate pain degrees during rectal probe insertion and prostate biopsy. Mean Motor Unit Potential (MUP) durations and amplitudes were recorded using EMG.

Results

The VAS scores during rectal probe insertion in Group 3 (INB) were significantly less than those in the other groups. The VAS scores during prostate biopsy in Group 3 were significantly less than those in the other groups. Mean MUP durations and amplitudes were significantly lesser in Group 3 than the other groups, during both procedures.

Conclusion

INB and intrarectal prilocaine–lidocaine cream application provided significantly better pain control than PNB and intrarectal prilocaine–lidocaine cream application.

Author(s): Argun Guldeniz and Selvi Ismail

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