RESUMO
TRUS guided biopsies is painfull and uncomfortable procedure; which could cause many complications up-to vasovagal attacks. Some patients can not sustain the procedure to complete his required biopsies either due to presence of anal disorders [fissures, piles. stenosis .. ] or untolerable pain during biopsy. The objective of this study was to evaluate the use of peri-anal and peri-prostatiic local infilterating aneasthesia prior to TRUS biopsy in patients with or without painful anal conditions. Five hundred patients who are subjected for TRUS biopsy were included in this study of them 150 patients were found to have painful anal problems [fissure, piles. tight anal canal]. Peri-anal infilterating aneasthesi were used only in [n=150] patients who complaining of anal problems while. periprostatic aneasthesia were performed in all included patients [n=500] of this study. DRE was routinly performed prior to TRUS 10 assess the presence of anal disorders and to evaluate the prostate. Local injection of xylocain 0.5% in perianal rectal muscle before the introduction or TRUS probe followed by peri-prostatic injection of the same anesthetic material which were injected in sagital axis started from the seminal vesicle base of each side or the prostate till the prostatic apex. Then TRUS evaluation of the prostate and its measures, presence of focal lesion and capsular integrity were done to give the proper time for aneasthia. Biopises were taken according to TRUS finding using the standard sixtant or the extended biopsy technique+/- lesion directed. Most of the patients [90%] were comfortable using this procedure without significant pain during TRUS guided biopsies. Only 3% of the patient feel mild pain during mid-zonal biopsy because of repeat biopsy. Patients with painful anal problems were comfortable without prior treatment or delay in the procedure. Some of this painful anal problems improved after the procedure [anal dilatation]
On conclusion: Peri-anal local infilterating aneasthesia solve the problem of TRUS biobsy in patients with painful anal problems without delay or the procedure. Peri-prostatic local infiltrating aneasthesia was safe and effective prior to TRUS guided biopsies for all patients