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document
Is periprostatic local anesthesia for transrectal ultrasound guided prostate biopsy associated with increased infectious or hemorrhagic complications ? A prospective randomized trial . PURPOSE Periprostatic local anesthesia for prostate biopsy requires 2 or more extra needle punctures and injection of the local anesthetic through the highly colonized rectum . To our knowledge we report the first prospective randomized trial to assess the infectious or hemorrhagic complications associated with this method . MATERIALS AND METHODS A total of 100 consecutive patients with sterile urine cultures underwent transrectal ultrasound guided prostate biopsy . They were randomized to receive a periprostatic nerve block or no anesthesia . Patients were evaluated for the amount of rectal and urethral bleeding , and symptoms and signs of infection after biopsy . RESULTS The amount of urethral bleeding was slight and similar in the 2 groups . Rectal bleeding was significantly less in the patients who received anesthesia . High fever ( greater than 37.8C ) was more frequent in the nerve block group and 2 patients in this group required rehospitalization . Bacteriuria in post-biopsy urine cultures was significantly more common in the anesthesia group . CONCLUSIONS Our results suggest that periprostatic local anesthesia for prostate biopsy does not increase the risk of urethral bleeding . It is associated with a decreased incidence of rectal bleeding , presumably due to decreased patient discomfort . The incidence of bacteriuria was significantly higher in the anesthesia group . High fever and hospitalization due to infectious complications were also more common in the local anesthesia group , although not statistically significant . Prospective randomized trials seem warranted to determine the optimum antibiotic prophylaxis regimen in patients undergoing biopsy with a periprostatic nerve block .
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Intervention_Physical
anesthesia
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Intervention_Surgical
transrectal ultrasound guided prostate biopsy
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Intervention_Physical
periprostatic nerve block
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Intervention_Physical
anesthesia
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Intervention_Physical
rectal and urethral bleeding
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Intervention_Physical
symptoms and signs of infection after
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Intervention_Surgical
biopsy
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Intervention_Physical
anesthesia
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Outcome_Adverse-effects
infectious or hemorrhagic complications
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Outcome_Adverse-effects
infectious or hemorrhagic complications
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Outcome_Physical
amount of rectal and urethral bleeding
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Outcome_Adverse-effects
infection after biopsy
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Outcome_Physical
amount of urethral bleeding
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Outcome_Physical
Rectal bleeding
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Outcome_Physical
High fever
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Outcome_Physical
Bacteriuria in post-biopsy urine cultures
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Outcome_Physical
urethral bleeding
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Outcome_Physical
rectal bleeding
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Outcome_Physical
bacteriuria
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Outcome_Adverse-effects
High fever and hospitalization
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Participant_Condition
transrectal ultrasound guided prostate biopsy
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Participant_Condition
100
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Participant_Condition
sterile urine cultures
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Participant_Condition
transrectal ultrasound guided prostate biopsy