The rectal administration of lidocaine gel and tolerance of transrectal ultrasonography-guided biopsy of the prostate: a prospective randomized placebo-controlled study

Objective To evaluate the effect of the rectal administration of lidocaine gel on the tolerance of systematic sextant transrectal ultrasonography (TRU S)-guided prostatic biopsies. Patients and methods From January to September 1997, patients undergoing in itial biopsy mapping of the prostate (with six systematic TRUS-guided trans rectal biopsies) were randomized using a pre-established randomization list into two groups. In group 1, 15 mt of 2% lidocaine gel (Astra, Sodertalje, Sweden) was administered intrarectally 15 min before the biopsies. In grou p 2 (placebo), 15 mt of trans-sonic hydrophilic gel (Rivadis Laboratory, Th ouars, France) was administered transrectally under the same conditions. Pa tients were randomized and the gel administered by a nurse; neither the pat ients nor the urologists were aware of which product was administered. At t he end of the procedure, patients were asked to score the severity of disco mfort of the biopsies, using a self-administered rating scale. Results In all, 109 patients were included, in either group 1 (56 patients) or group 2 (53 patients). Slight pain or no pain was experienced by the oa st majority of patients in both groups. Moderate to severe pain was experie nced in 12.5% of patients in group 1 and 11.3% of patients in group 2, Ther e was no difference in patient tolerance between the groups (P = 0.39). Onl y minor complications occurred and complication rates were not significantl y different between the groups. Conclusion The rectal administration of lidocaine has no impact on the tole rance to prostatic biopsy.