Pavlos Zoumpoulis PhD, Presenter: Nothing to Disclose

Dimitris Alexopoulos, Abstract Co-Author: Nothing to Disclose

Athina Plagou, Abstract Co-Author: Nothing to Disclose

Anna Filippidou MD, Abstract Co-Author: Nothing to Disclose

Kelly Pahos, Abstract Co-Author: Nothing to Disclose

Ioannis Theotokas MD, Abstract Co-Author: Nothing to Disclose

1. To discuss the indications for the use of local anesthesia prior to TRUS. 2. To demonstrate the procedure of TRUS guided local anesthesia before prostate biopsy. 3. To estimate the efficacy of TRUS guided local anesthesia before prostate biopsy.

Administration of local anesthesia prior to TRUS-guided biopsy efficiently eliminates patient discomfort allowing for greater number of biopsies. 2700 TRUS-guided prostate biopsies have been performed following local periprostatic anesthesia from 2000-2005. The procedure begins by injecting 8-15 cc of Xylocaine and 2% adrenaline through the biopsy needle. The technique, its effects on the US image, complications and side effects were compared to 8500 US-guided biopsies performed between the years 1994-2004, without local anesthesia. There was no significant difference between the number and severity of complications in the group with local anesthesia compared to the group without anesthesia.

There was a significant difference between the number and severity of complications in the group with local anesthesia compared to the group without anesthesia: Urinary retention (-30%), severe hematuria (-40%) and urinary infection and septicemia (-32%). There were no significant side effects caused by the infusion of the anesthesia drug. Air bubbles are sometimes infused with the drug causing a "fuzzy" image, which results in a degree of difficulty in guiding the needle. A thorough TRUS examination of the prostate prior to the anesthesia helps the radiologist guide the needle to the appropriate area, even through a "fuzzy" image.

US-guided local anesthesia, before TRUS biopsy, assures patient cooperation and is essential for a large (more than 10) number of biopsies. We also noticed a significant reduction of the number and severity of complications.

1. To discuss the indications for the use of local anesthesia prior to TRUS. 2. To demonstrate the procedure of TRUS guided local anesthesia before prostate biopsy. 3. To estimate the efficacy of TRUS guided local anesthesia before prostate biopsy.

Administration of local anesthesia prior to TRUS-guided biopsy efficiently eliminates patient discomfort allowing for greater number of biopsies. 2700 TRUS-guided prostate biopsies have been performed following local periprostatic anesthesia from 2000-2005. The procedure begins by injecting 8-15 cc of Xylocaine and 2% adrenaline through the biopsy needle. The technique, its effects on the US image, complications and side effects were compared to 8500 US-guided biopsies performed between the years 1994-2004, without local anesthesia. There was no significant difference between the number and severity of complications in the group with local anesthesia compared to the group without anesthesia.

There was a significant difference between the number and severity of complications in the group with local anesthesia compared to the group without anesthesia: Urinary retention (-30%), severe hematuria (-40%) and urinary infection and septicemia (-32%). There were no significant side effects caused by the infusion of the anesthesia drug. Air bubbles are sometimes infused with the drug causing a "fuzzy" image, which results in a degree of difficulty in guiding the needle. A thorough TRUS examination of the prostate prior to the anesthesia helps the radiologist guide the needle to the appropriate area, even through a "fuzzy" image.

US-guided local anesthesia, before TRUS biopsy, assures patient cooperation and is essential for a large (more than 10) number of biopsies. We also noticed a significant reduction of the number and severity of complications.

Zoumpoulis, P, Alexopoulos, D, Plagou, A, Filippidou, A, Pahos, K, Theotokas, I, Local Anesthesia before TRUS-guided Prostate Biopsy: A Way to Perform More Biopsies with No Pain and Fewer Complications.  Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL. http://archive.rsna.org/2005/4408028.html