Lidocaine Suppositories Curb Prostate Biopsy Pain

NEW YORK (Reuters Health) - Men undergoing a prostate biopsy may experience less discomfort if they're given a suppository containing the local anesthetic lidocaine a couple of hours before the procedure.

While a biopsy when prostate cancer is suspected can be life saving -- or help avoid unnecessary surgery if it proves negative -- the procedure can be uncomfortable or even painful. It involves insertion of an ultrasound probe into the rectum so the prostate can be visualized, and then triggering a needle to retrieve several core samples of the gland for examination by a pathologist.

Now, Austrian researchers report that lidocaine suppositories are more effective than lidocaine gel in reducing pain during transrectal prostate biopsy, the standard procedure for diagnosing prostate cancer.

The findings, which appear in the medical journal BJU International, are based on a study of 100 men who were assigned in random fashion to get lidocaine gel rectally 10 minutes before biopsy, a lidocaine suppository 1 or 2 hours before the procedure, or a placebo suppository 10 minutes before being biopsied.

The average pain scores with the lidocaine suppositories were significantly lower than with the other treatments, particularly when the suppositories were applied 2 hours before biopsy, report Dr. Klaus G. Fink and colleagues, from the Paracelsus Private Medical University in Salzburg.

Compared with subjects given placebo suppositories, those given lidocaine suppositories 2 hours before biopsy reported 71 percent less pain. Moreover, the cost of the lidocaine suppositories per application was roughly 25 percent lower than that of lidocaine gel.

"As suppositories are easy to handle and cheap, they are recommended for routine prostate biopsy," the researchers conclude.

SOURCE: BJU International, November 2005.