Combination of perianal-intrarectal @entity3303 - @entity5403 cream and XXXX for @entity158 control during transrectal ultrasound guided prostate biopsy: a randomized, controlled trial.

@entity1 @entity5403 @entity3303 @entity158 @entity616
PURPOSE: To our knowledge the optimal analgesia during prostate biopsy remains undetermined. We tested the efficacy and safety of combined perianal-intrarectal @entity3303 - @entity5403 cream and @entity616 during transrectal ultrasound guided prostate biopsy. MATERIALS AND METHODS: A total of 280 @entity1 were randomized to receive combined perianal-intrarectal @entity3303 - @entity5403 cream and @entity616 (group 1), perianal-intrarectal @entity3303 - @entity5403 cream alone (group 2), @entity616 alone (group 3) or no anesthesia (group 4) before transrectal ultrasound guided prostate biopsy. @entity158 was evaluated with a 10-point visual analog scale at subsequent procedural steps, including perianal-intrarectal substance administration, prostate transrectal ultrasound, @entity616 and sampling. Complications were assessed by self-administered questionnaire and telephone interview. RESULTS: The groups were comparable in @entity1 age, prostate volume, pathology results and visual analog scale perianal-intrarectal substance administration. Visual analog scale results for transrectal ultrasound were lower in groups 1 and 2 vs 3 and 4 (mean 1.5 and 1.41 vs 5.37 and 5.31, p <0.001) and results for @entity616 were lower in group 1 vs 3 (mean 1.03 vs 3.74, p <0.001). Results for sampling were lower in groups 1 to 3 vs 4 (mean 0.77, 1.27 and 1.27 vs 4.33, p <0.001) and in group 1 vs 2 and 3 (p <0.001). Stratified analysis showed that visual analog scale sampling was lower in group 1 vs 2 and 3 in @entity1 65 years old or younger, those with a prostate greater than 49 cc and those with lower anorectal compliance (visual analog scale results for perianal-intrarectal substance administration greater than 2) (p = 0.006, <0.001 and 0.003, respectively). The overall complication rate was similar in all 4 groups (p = 0.87). CONCLUSIONS: Our findings suggest that the combination of perianal-intrarectal @entity3303 - @entity5403 cream and @entity616 provides better @entity158 control than the 2 modalities alone during the sampling part of transrectal ultrasound guided prostate biopsy with no increase in the complication rate. The magnitude of this effect is higher in younger @entity1 , @entity1 with a larger prostate and @entity1 with lower anorectal compliance.
