Modified perianal/pericapsular anesthesia for transrectal biopsy of prostate in patients with anal rectal problems

Objectives To modify our technique of perianal anesthesia and use it in patients with painful conditions of the rectum and/or anus. Methods A total of 31 consecutive patients with anal-rectal problems underwent prostate needle biopsy. Of these, 17 were referred to our hospital after vain attempts to insert a transrectal ultrasound probe. Patients received a perianal-pericapsular injection of 1% lidocaine. Pain perception was separately assessed for probe insertion and biopsies using a visual pain analog score. Results Only in 1 patient were we unable to insert the transrectal ultrasound probe. The mean patient age was 65.28 ± 5.35 years. We performed a mean of 12.25 biopsies per case. At probe insertion, the mean pain score was 2.2 ± 0.83. During the biopsy punctures, the mean pain level was 2.53 ± 1.054. We did not find any increase in the complication rate related to the anesthesia method. Conclusions Modified perianal anesthesia can be used for transrectal ultrasound-guided biopsy of the prostate in patients with anal-rectal problems, because it provides significant pain relief.