Indian Journal of Urology Users online:1482  
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Year : 2006  |  Volume : 22  |  Issue : 2  |  Page : 118-121

Apical block versus basolateral prostatic plexus block in transrectal ultrasound guided prostatic biopsy: A prospective randomized study

Department of Urology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India

Correspondence Address:
N Khurana
Department of Urology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow - 226 014
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0970-1591.26564

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OBJECTIVES: We prospectively analyzed the efficacy and safety of apical block, bilateral (B/L) basolateral prostatic plexus block and unilateral (U/L) basolateral prostatic plexus block in patients undergoing transrectal ultrasound (TRUS)- guided prostatic biopsies. MATERIALS AND METHODS: From July 2003 to July 2004, 60 patients of median age 63 yrs and median PSA of15.8 ng/ml, underwent TRUS- guided prostatic biopsies. These biopsies were performed in the left lateral position, after cleansing enema and single dose of antibiotic. Patients were randomized into 3 groups. Under TRUS guidance, group1 (n=20) received 10 ml of 1% lignocaine at the apical area of the prostate, group 2 (n=20) received 5 ml of 1% lignocaine in the basolateral prostatic plexus bilaterally and group 3 (n=20) received 10 ml of 1% lignocaine at basolateral prostatic plexus unilaterally, using an 18 F needle. Five minutes after the injection, a series of 10 prostatic biopsies were performed. Pain during biopsy was assessed using visual analogue pain score. RESULTS: Patients with apical prostatic block had significantly lower pain scores (1.5 0.9) than those with B/L (2.6 1.2) and U/L basolateral prostatic plexus block (2.8 1.4). The three groups were similar in regard to age, prostatic volume and number of cores. CONCLUSIONS: Apical prostatic plexus block was the most effective technique and could be a useful alternative to basolateral prostatic plexus block.

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