DOI: https://doi.org/10.36347/sjams.2024.v12i08.021

Pages: 1042-1048

Background: Although Transrectal ultrasound (TRUS) guided prostate biopsy is safe, patients experience significant pain during the procedure. In recent times, periprostatic nerve block (PNB) is the most preferable method for prostate biopsy, however, several studies suggested that PNB does not completely eliminate pain. Objective: This study aimed to compare the effect of PNB alone versus a combination of PNB and intraprostatic local anesthesia on pain reduction in TRUS guided prostate biopsy. Methods: A quasi-experimental study was conducted at Dhaka Medical College Hospital from January to December 2021. A total of 124 patients undergoing TRUS guided prostate biopsy were purposively included. Patients were divided into two groups using alternate sequence allocation: Group A (combined PNB and intraprostatic local anesthesia) and Group B (PNB alone). Pain was measured using the Visual Analogue Scale (VAS) during probe insertion, anesthetic infiltration, biopsy, and 30 minutes post-procedure. Biopsy-related complications were also recorded. Results: There were no significant differences between groups in terms of age (p=0.115), number of nodules (p=0.471), PSA levels (p=0.201), prostate volume (p=0.597), or procedure time (p=0.903). Pain scores during probe insertion and anesthetic infiltration were similar between the groups (p>0.05). However, during biopsy, Group A had significantly lower VAS scores (3.00 ±0.36) compared to Group B (4.79 ±0.58) (p<0.001). Thirty minutes after the procedure, Group A also reported significantly lower pain (VAS: 1.14 ±0.35) than Group B (VAS: 2.84 ±0.37) (p<0.001). Complications such as hematuria, dysuria, hematochezia, hematospermia, and UTI showed no significant difference between groups (p>0.05). Conclusion: Combining PNB with intraprostatic local anesthesia significantly reduces pain compared to PNB alone, without increasing complications.