Lidocaine suppository for transrectal ultrasound-guided biopsy of the prostate: a prospective, double-blind, randomized study.

Aims: To investigate analgesia using lidocaine suppositories for prostate biopsy.

Methods: From 2007 to 2009, 160 patients underwent transrectal ultrasound-guided prostate biopsy at the Department of Urology, KBC Zagreb. 80 patients received a 60-mg lidocaine suppository intrarectally at different time points from 15 to 120 min before biopsy and 80 patients received a glycerin suppository as placebo. The pain level was evaluated using a visual analogue scale (VAS).

Results: There were no statistically significant differences between the groups, i.e. they were similar regarding patients' age, prostate-specific antigen levels, prostate volume and the incidence of diagnosis of malignancy on biopsy. The mean pain score in the lidocaine group (3 ± 1) was significantly lower than the mean pain score in the glycerin group (4.1 ± 1.3) (p < 0.001). A noticeable trend towards lower pain scores in the lidocaine group was observed with more time elapsing from placing the suppository till the biopsy and the optimal time for performing biopsy starting approximately 1 h after placing the suppository.

Conclusions: Lidocaine suppositories are an easy-to-use, self-applicable (by the patient) and cheap method of local analgesia, with acceptable results. Possible complications related to this procedure are insignificant.