The effect of local anesthesia types on erectile function in TRUS biopsy: A prospective study

Aim: To evaluate the effect of local anesthesia types on erectile function during transrectal ultrasound guided biopsy (TRUS-Bx). Methods: Between February 2014 and February 2015, 50 men who underwent TRUS-Bx at our institution were included in this prospective study. The 50 patients were randomized and divided into two groups according to the type of anesthesia used. All patients were asked to indicate the level of pain experienced on a visual analogue scale (VAS) 10 min after the TRUS biopsy. All patients had to fill in the IIEF standardized questionnaire. Groups were evaluated in terms of pre-biopsy IEFF score (IIEF-1), post-biopsy 1st month IIEF score (IIEF-2) and post-biopsy 2nd month IIEF score (IIEF -3). Patient characteristics, mean VAS score and IIEF score were compared between the two groups. Results: The mean age, IIEF-1, tPSA level, prostate volume and VAS score were 60.86±0.95 years, 18.68,6.81±0.54 ng/ml, 51.10±3.82 cc and 3.5±0.26 in all patients, respectively. The difference in VAS scores between the groups was statistically significant. In Group 1 the IIEF-1, IIEF-2, and IIEF3 were different from each other statistically. There was no statistically significant difference between IIEF-1 and IIEF-3 scores in group 2. So it was observed that the initial IIEF scores were reached at the end of the second month in group 2 administered 12.5 g 2% lidocaine HCl gel. Conclusion: Our study indicates that although local periprostatic anesthesia by injecting 6 ml of 2% lidocaine provides more effective anesthesia for pain relief, intrarectal 12.5g 2% lidocaine HCl gel maintains less impact on erectile dysfunction for TRUS-Bx.