Abstract
Periprostatic nerve block has been reported to be an effective form of anesthesia for prostatic surgery. Recent studies have shown the simplicity and the efficacy of a transrectal approach for periprostatic nerve block. The goal of our study was to evaluate the effect of a transrectal periprostatic nerve block on the discomfort associated with rigid cystoscopy. A total of 73 patients underwent cystoscopy. Group 1 (n=39) received a transrectal periprostatic lidocaine infiltration prior to the cystoscopy. Group 2 (n=34) underwent cystoscopy alone. The pain that patients experienced during cystoscopy was assessed on a visual analog scale. The patients in the two groups were very similar in regard to age and size of the prostate. The mean pain score was 3.4 in group 1 and 3.9 in group 2. This difference was not statistically significant. We conclude that nerve block does not seem to reduce the pain associated with transurethral manipulations.
Similar content being viewed by others
References
Adamakis I, Mitropoulos D, Haritopoulos K, Alamanis C, Stravodimos K, Giannopoulos A (2004) Pain during transrectal ultrasonography guided prostate biopsy: a randomized prospective trial comparing periprostatic infiltration with lidocaine with the intrarectal instillation of lidocaine-prilocain cream. World J Urol 22(4):281–284
Alavi AS, Soloway MS, Vaidya A, Lynne CM, Gheiler EL (2001) Local anesthesia for ultrasound guided prostate biopsy: a prospective randomized trial comparing 2 methods. J Urol 166(4):1343–1345
Goldfischer ER, Cromie WJ, Karrison TG, Naszkiewicz L, Gerber GS (1997) Randomized, prospective, double-blind study of the effects on pain perception of lidocaine jelly versus plain lubricant during outpatient rigid cystoscopy. J Urol 157(1):90–94
Graversen PH, Gasser TC, Larsen EH, Dorflinger T, Bruskewitz RC (1987) Transurethral incisions of the prostate under local anaesthesia in high-risk patients: a pilot study. Scand J Urol Nephrol Suppl 104:87–90
Issa MM, Ritenour C, Greenberger M, Hollabaugh R Jr, Steiner M (1998) The prostate anesthetic block for outpatient prostate surgery. World J Urol 16(6):378–383
Issa MM, Stein B, Benson R, Knoll LD, Fay R (2000) Prospective multicenter study of transperineal prostatic block for transurethral needle ablation of the prostate. Urology 56(6):1052–1055
Leach GE, Sirls L, Ganabathi K, Roskamp D, Dmochowski R (1994) Outpatient visual laser-assisted prostatectomy under local anesthesia. Urology 43(2):149–153
Moffat NA (1977) Transurethral prostatic resections under local anesthesia. J Urol 118(4):607–608
Nash PA, Bruce JE, Indudhara R, Shinohara K (1996) Transrectal ultrasound guided prostatic nerve blockade eases systematic needle biopsy of the prostate. J Urol 155(2):607–609
Orandi A (1984) Urological endoscopic surgery under local anesthesia: a cost-reducing idea. J Urol 132(6):1146–1147
Paick JS, Donatucci CF, Lue TF (1993) Anatomy of cavernous nerves distal to prostate: microdissection study in adult male cadavers. Urology 42(2):145–149
Schlegel PN, Walsh PC (1987) Neuroanatomical approach to radical cystoprostatectomy with preservation of sexual function. J Urol 138(6):1402–1406
Seymour H, Perry MJ, Lee-Elliot C, Dundas D, Patel U (2001) Pain after transrectal ultrasonography-guided prostate biopsy: the advantages of periprostatic local anaesthesia. BJU Int 88(6):540–544
Tabet BG, Levine S (1996) Nerve block in prostate surgery. J Urol 156(5):1659–1661
von Knobloch R, Weber J, Varga Z, Feiber H, Heidenreich A, Hofmann R (2002) Bilateral fine-needle administered local anaesthetic nerve block for pain control during TRUS-guided multi-core prostate biopsy: a prospective randomised trial. Eur Urol 41(5):508–514; discussion 514
Walsh PC, Lepor H, Eggleston JC (1983) Radical prostatectomy with preservation of sexual function: anatomical and pathological considerations. Prostate 4(5):473–485
Zlotta AR, Schulman CC (1999) Interstitial laser coagulation for the treatment of benign prostatic hyperplasia using local anaesthesia only. BJU Int 83(3):341–342
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Müntener, M., Fatzer, M., Praz, V. et al. Local anesthesia for transurethral manipulations: is a transrectal periprostatic nerve block effective?. World J Urol 23, 349–352 (2005). https://doi.org/10.1007/s00345-005-0020-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00345-005-0020-8