Comparison between ultrasound-guided and digital-guided anesthesia preparating patients for prostatic biopsy

Objective: Our target in this study is to evaluate the efficacy of ultrasound-guided anesthesia comparing it to the digital-guided one, considering pain and discomfort reduction, during prostate biopsy. Materials and methods: We analyzed 150 patients that undergone prostate biopsy between March 2011 and January 2012; conditions to enter the sample were: elevated PSA levels and/or psa ratio free/total less than 15% and/or detection of alteration via ultrasound examination and/or a positive outcome of a digital rectal examination. Patients were randomized into two groups. In 75 patients (Group A) was performed local US-guided anesthesia with a dose of 10 ml of mepivacaine 1%, in the other 75 patients (Group B) was performed a local digitalguided anesthesia, again with an equal dose of 10 ml of mepivacaine 1%. After the biopsy patients were kept under observation for two hours, then they have been asked to provide description of the pain experienced during biopsy, using a 10-point visual analog scale (Visual Analogue Scale; 0 for no pain, 10 for excruciating pain). Results: In Group A, 49 patients expressed a VAS value of zero, 23 of them a value of 1 and 2 marked a value of 3. On the other side, in Group B, 9 patients marked a VAS value of 1, 36 a value of 2, 28 marked 3 and 2 patients expressed a value of 4. The comparison patients in Group A expressed VAS values statistically lower than patients in Group B (t Student Test, p < 0,01). Conclusions: The ultrasound-guided prostatic anesthesia is preferable to the digital-guided type, because it considerably reduce this procedure-related pain.