Autorino Riccardo, De Sio Marco, Di Lorenzo Giuseppe, Damiano Rocco, Perdonà Sisto, Cindolo Luca, D'Armiento Massimo
Urology Clinic, Second University, Department of Oncology, Federico II University, Vico Santo Spirito 54, 80132 Naples, Italy.
J Urol. 2005 Dec;174(6):2091-7. doi: 10.1097/01.ju.0000181212.51025.06.
There is growing interest among urologists on the need for decreasing pain during transrectal ultrasound (TRUS) guided prostate biopsy.
We performed a systematic MEDLINE search of clinical trials of any kind of anesthesia, analgesia or sedation during TRUS guided prostate biopsy published since 2000. We critically analyzed the impact of pain and discomfort associated with the procedure, the described methods for evaluating it and the different techniques that have been described.
There is strong evidence in the current literature that patient tolerance and comfort during TRUS guided prostate biopsy can be improved by anesthesia/analgesia. What remains is the need to urge all urologists to introduce it in clinical practice as a routine part of the procedure, whatever the biopsy scheme.
Of the various options periprostatic anesthetic infiltration has been shown to be safe, easy to perform and highly effective. It should be considered the gold standard at the moment, even if the optimal technique remains to be established. Further studies addressing this issue are warranted.
泌尿外科医生对于在经直肠超声（TRUS）引导下前列腺穿刺活检过程中减轻疼痛的需求日益增加。
我们对2000年以来发表的关于TRUS引导下前列腺穿刺活检期间任何类型麻醉、镇痛或镇静的临床试验进行了系统的MEDLINE检索。我们严格分析了与该操作相关的疼痛和不适的影响、所描述的评估方法以及已描述的不同技术。
当前文献中有强有力的证据表明，麻醉/镇痛可改善TRUS引导下前列腺穿刺活检期间患者的耐受性和舒适度。剩下的是需要敦促所有泌尿外科医生将其作为该操作的常规部分引入临床实践，无论活检方案如何。
在各种选择中，前列腺周围麻醉浸润已被证明是安全、易于实施且高效的。目前应将其视为金标准，即使最佳技术仍有待确立。有必要开展进一步研究来解决这个问题。
