Emory Report

July 10, 2000

 Volume 52, No. 37

Health Sciences

Gel greatly reduces prostate biopsy pain

By Lillian Kim

Emory researchers have found that a common anesthetic is an easy and effective solution for the pain most men endure during transrectal prostate biopsy, a diagnostic surgical procedure used to test for prostate cancer.

In a study of 50 patients at the VA Hospital, those who received rectally administered lidocaine gel before the biopsy experienced significantly less pain than those who underwent the biopsy the conventional way, without anesthetic.

"We've found a way to make the prostate biopsy more tolerable and less distressing," said Emory urologist Muta Issa, who directed the study. The results were presented at the American Urological Association's 95th annual meeting in Atlanta in May.

Without anesthetic, the prostate biopsy can be quite uncomfortable, as it involves inserting several biopsy needles into the prostate through the rectum. Each needle removes a tiny cylinder of tissue 1/16th of an inch in diameter, which is then analyzed for the presence of cancerous cells.

In the study, 52 percent of patients who underwent the procedure without lidocaine rated their pain as five or higher on a pain scale of one to 10. Scores of 5 or higher are considered moderate to severe pain.

But only 4 percent of patients who received lidocaine rated their pain within that range.

"This goes a long way toward improving patient comfort," said Issa, chief of urology at the VA and an assistant professor of urology in the School of Medicine.

A transrectal prostate biopsy is performed in patients who have had an abnormal prostate exam and/or whose blood tests show elevated prostate-specific antigen (PSA), anindicator of possible prostate cancer.

Prostate cancer is the second leading cancer cause of death in American men. This year the American Cancer Society estimates about 180,400 new cases of prostate cancer will be diagnosed in the U.S., and 31,900 men will die from the disease.

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