December 5, 2005

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

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

SOURCE: BJU International, November 2005.