Active surveillance for localized prostate cancer

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Bull Urooncol 2012;11(2):114-118

Transrectal ultrasonography (TRUS) guided prostate biopsy is the gold standard method used to diagnose prostate cancer. Today, anesthesia during prostate biopsy is considered mandatory. In this review, different anesthetic methods can be used in TRUS-guided prostate biopsy discussed in light of the current literature.

Anesthesia methods during TRUS-guided prostate biopsy can group under three main headings: Local or regional anesthesia, combinations of local anesthesia with systemic analgesia, and sedoanalgesia.

Periprostatic nerve blockage, regardless of patient age and the number of cores taken, provided the gold standard method of pain control and comfort. The most widely used drug is 1% or 2% lidocaine because of low incidence of side effects, low cost and efficacy. The combination of periprostatic nerve blockage and intrarectal local anesthesia can be preferred because it reduces pain during the probe entry and manipulation, especially in young patients.