0,05), ortalama PSA değerleri 97,3$pm$66,85 ve 44,1$pm$19,56 ng/ml. (p>0,05) olarak saptanmıştır. Dijital rektal muayene birinci gruptaki hastaların % 35,6'sında (n=32), diğer gruptaki hastaların % 23,3'ünde (n=21) anormal olarak değerlendirilmiştir. TRUS'da ortalama prostat volümleri 1. grupta 58,9$pm$4,1 cc, 2. grupta ise 54,3$pm$3,6 cc (p>0,05) olarak ölçülmüştür. Histolojik değerlendirme sonucunda ilk gruptaki hastaların % 32,2'sinde (n=29), diğer grupta ise % 28,9'unda (n=26) prostat kanseri tanısı konmuştur. Birinci grupta ağrı skoru ortalama 4,8$pm$0,27, ikinci grupta ise 2,1$pm$0,28 olarak bulunmuştur (p<0,0001). Hastalarda lidokaine bağlı yan etki görülmemiştir. Intrarektal lidokain jel uygulaması transrektal prostat biyopsisi gereken hastalarda anestezi açısından basit, güvenli ve etkili bir yöntemdir. Transrektal ultrasonografı eşliğinde prostat iğne biyopsisi sırasında tüm hastalara rutin olarak basit bir yöntem olan intrarektal % 2'lik lidokain jel uygulanmasını önermekteyiz. Introduction: Nowadays, prostatic biopsy under transrectal ultrasound guidance has evolved into a standard procedure in the diagnosis of prostate cancer. Generally, it is considered to be not or only mildly uncomfortable and is consequently performed without anesthesia or analgesia. However, significant counts of men have been declared discomfort and pain after the procedure. Recent reports have indicated the benefit of anesthesia during prostate biopsy. We prospectively evaluated the safety and efficacy of intrarectal lidochine gel instillation as an anesthesia during transrectal prostate biopsy. Materials and Methods: Of 180 consecutive men undergoing transrectal ultrasound-guided prosjtate biopsy in May 1998 - May 2002 were enrolled in this study. Indications for the procedure were an abnormal prostate on digital rectal examination and/or elevated serum prostate specific antigen. Study exclusion criteria were a history of transrectal prostate biopsy, chronic prostatitis or prostatodynia, active anal and rectal conditions such as hemorrhoids, anal fissures or stricture, neurological conditions, allergy to lidocaine or-the concomitant use of analgesic and narcotic medications. Patients were randomized into two groups. Group 1 (n=90) control who received 10 cc intrarectal lubricant and group 2 (n=90) who received 10 cc of 2% intrarectal lidocaine 10 minutes before the procedure. No narcotics, sedation or analgesia was given. Prophylactic (400 mg.) ofloxacin were also given orally 12 hours before biopsy, and same dosage per day %as given to patient for four days. All men underwent bowel cleansing before the procedure. Patients were placed in the lithotomy position and transrectal ultrasound was performed using General Electric a 100 Logic with a 6.5 MHz transrectal sector scanner. Biopsies were taken with a biopsy gun using 18 gauge "Tru-cut" biopsy needles. Pain during biopsy was assessed using a 10-point linear visual analog pain scale. Results: In groups 1 and 2 mean patient age was 68.96±0.93 and 67.6$pm$0.80 years (p>0.05), and mean PSA level was 97.3$pm$66.85 and 44.1±19.56 ng/ml. (p>0.05). Digital rectal examination was normal and abnormal in 35.6% (n=32) group 1, and 23.3% (n=21) group 2 patients, respectively. Transrectal ultrasound showed a mean prostate volume of 58.9$pm$4.1 cc in group 1 and 54.3±3.6 cc in group 2 (p>0.05). Final histological results revealed prostate cancer in 29 men (32.2%) in group 1 and 26 men (28.9%) in group 2. The mean pain score during transrectal prostate biopsy was 4.8±0.27 and 2.110.28 in groups 1 and 2, respectively (p<0.0001). No adverse events were noted to lidocaine. Conclusion: Intrarectal lidocaine gel is a simple, safe and efficacious method of providing satisfactory anesthesia in men undergoing transrectal prostate biopsy. We recommend its routine administration of intrarectal 2% lidocaine gel in all patients during this procedure.">
[PDF] Transrektal ultrason eşliğinde prostat biyopsisinde intrarektal lokal anestezinin etkinliği: Prospektif randomize bir çalışma | [PDF] Efficacy of intrarectal local anesthesia during transrectal ultrasonography guided biopsy: A randomized prospective study
0,05), ortalama PSA değerleri 97,3$pm$66,85 ve 44,1$pm$19,56 ng/ml. (p>0,05) olarak saptanmıştır. Dijital rektal muayene birinci gruptaki hastaların % 35,6'sında (n=32), diğer gruptaki hastaların % 23,3'ünde (n=21) anormal olarak değerlendirilmiştir. TRUS'da ortalama prostat volümleri 1. grupta 58,9$pm$4,1 cc, 2. grupta ise 54,3$pm$3,6 cc (p>0,05) olarak ölçülmüştür. Histolojik değerlendirme sonucunda ilk gruptaki hastaların % 32,2'sinde (n=29), diğer grupta ise % 28,9'unda (n=26) prostat kanseri tanısı konmuştur. Birinci grupta ağrı skoru ortalama 4,8$pm$0,27, ikinci grupta ise 2,1$pm$0,28 olarak bulunmuştur (p<0,0001). Hastalarda lidokaine bağlı yan etki görülmemiştir. Intrarektal lidokain jel uygulaması transrektal prostat biyopsisi gereken hastalarda anestezi açısından basit, güvenli ve etkili bir yöntemdir. Transrektal ultrasonografı eşliğinde prostat iğne biyopsisi sırasında tüm hastalara rutin olarak basit bir yöntem olan intrarektal % 2'lik lidokain jel uygulanmasını önermekteyiz.">
0,05), ortalama PSA değerleri 97,3$pm$66,85 ve 44,1$pm$19,56 ng/ml. (p>0,05) olarak saptanmıştır. Dijital rektal muayene birinci gruptaki hastaların % 35,6'sında (n=32), diğer gruptaki hastaların % 23,3'ünde (n=21) anormal olarak değerlendirilmiştir. TRUS'da ortalama prostat volümleri 1. grupta 58,9$pm$4,1 cc, 2. grupta ise 54,3$pm$3,6 cc (p>0,05) olarak ölçülmüştür. Histolojik değerlendirme sonucunda ilk gruptaki hastaların % 32,2'sinde (n=29), diğer grupta ise % 28,9'unda (n=26) prostat kanseri tanısı konmuştur. Birinci grupta ağrı skoru ortalama 4,8$pm$0,27, ikinci grupta ise 2,1$pm$0,28 olarak bulunmuştur (p<0,0001). Hastalarda lidokaine bağlı yan etki görülmemiştir. Intrarektal lidokain jel uygulaması transrektal prostat biyopsisi gereken hastalarda anestezi açısından basit, güvenli ve etkili bir yöntemdir. Transrektal ultrasonografı eşliğinde prostat iğne biyopsisi sırasında tüm hastalara rutin olarak basit bir yöntem olan intrarektal % 2'lik lidokain jel uygulanmasını önermekteyiz. Introduction: Nowadays, prostatic biopsy under transrectal ultrasound guidance has evolved into a standard procedure in the diagnosis of prostate cancer. Generally, it is considered to be not or only mildly uncomfortable and is consequently performed without anesthesia or analgesia. However, significant counts of men have been declared discomfort and pain after the procedure. Recent reports have indicated the benefit of anesthesia during prostate biopsy. We prospectively evaluated the safety and efficacy of intrarectal lidochine gel instillation as an anesthesia during transrectal prostate biopsy. Materials and Methods: Of 180 consecutive men undergoing transrectal ultrasound-guided prosjtate biopsy in May 1998 - May 2002 were enrolled in this study. Indications for the procedure were an abnormal prostate on digital rectal examination and/or elevated serum prostate specific antigen. Study exclusion criteria were a history of transrectal prostate biopsy, chronic prostatitis or prostatodynia, active anal and rectal conditions such as hemorrhoids, anal fissures or stricture, neurological conditions, allergy to lidocaine or-the concomitant use of analgesic and narcotic medications. Patients were randomized into two groups. Group 1 (n=90) control who received 10 cc intrarectal lubricant and group 2 (n=90) who received 10 cc of 2% intrarectal lidocaine 10 minutes before the procedure. No narcotics, sedation or analgesia was given. Prophylactic (400 mg.) ofloxacin were also given orally 12 hours before biopsy, and same dosage per day %as given to patient for four days. All men underwent bowel cleansing before the procedure. Patients were placed in the lithotomy position and transrectal ultrasound was performed using General Electric a 100 Logic with a 6.5 MHz transrectal sector scanner. Biopsies were taken with a biopsy gun using 18 gauge "Tru-cut" biopsy needles. Pain during biopsy was assessed using a 10-point linear visual analog pain scale. Results: In groups 1 and 2 mean patient age was 68.96±0.93 and 67.6$pm$0.80 years (p>0.05), and mean PSA level was 97.3$pm$66.85 and 44.1±19.56 ng/ml. (p>0.05). Digital rectal examination was normal and abnormal in 35.6% (n=32) group 1, and 23.3% (n=21) group 2 patients, respectively. Transrectal ultrasound showed a mean prostate volume of 58.9$pm$4.1 cc in group 1 and 54.3±3.6 cc in group 2 (p>0.05). Final histological results revealed prostate cancer in 29 men (32.2%) in group 1 and 26 men (28.9%) in group 2. The mean pain score during transrectal prostate biopsy was 4.8±0.27 and 2.110.28 in groups 1 and 2, respectively (p<0.0001). No adverse events were noted to lidocaine. Conclusion: Intrarectal lidocaine gel is a simple, safe and efficacious method of providing satisfactory anesthesia in men undergoing transrectal prostate biopsy. We recommend its routine administration of intrarectal 2% lidocaine gel in all patients during this procedure.">
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