Topical glyceryl trinitrate eases prostate biopsy discomfort
Monday, 29 November 1999 19:00 | 
| Medicexchange News - Medicexchange News |
Glyceryl trinitrate ointment is an effective adjunct to periprostatic nerve block in reducing pain and discomfort associated with transrectal ultrasonography (TRUS)-guided prostatic biopsy, according to UK researchers.
Glyceryl trinitrate ointment is an effective adjunct to periprostatic nerve block in reducing pain and discomfort associated with transrectal ultrasonography (TRUS)-guided prostatic biopsy, according to UK researchers.
In the September issue of BJU International, Dr. John E. McCabe and colleagues at Leighton Hospital, Crewe note that insertion of the rectal ultrasound probe is experienced before the block can be applied. Patients have described this as most uncomfortable.
Glyceryl trinitrate (GTN) ointment has been shown to reduce anal sphincter tone, and the team randomized 148 patients to receive 0.2 per cent GTN or placebo ten minutes before undergoing a 12-core biopsy. All were given 10 mL of lidocaine one per cent as local anesthesia before the biopsy procedure.
Patients who received GTN gave a significantly lower rating of pain due to probe insertion on a ten-point visual analogue scale (1.94) compared to those given placebo (3.24).
Pain perception for the whole procedure was lower in the active treatment group (2.13 versus 4.61), particularly for men aged less than 60 years.
Ten per cent of the GTN group reported headache, which was relieved with simple analgesia before they left the facility.
Summing up, the researchers conclude that topical GTN is safe and effective and "might be of maximum benefit in the younger patient and those having a repeat biopsy who previously failed to tolerate the procedure well.
In the September issue of BJU International, Dr. John E. McCabe and colleagues at Leighton Hospital, Crewe note that insertion of the rectal ultrasound probe is experienced before the block can be applied. Patients have described this as most uncomfortable.
Glyceryl trinitrate (GTN) ointment has been shown to reduce anal sphincter tone, and the team randomized 148 patients to receive 0.2 per cent GTN or placebo ten minutes before undergoing a 12-core biopsy. All were given 10 mL of lidocaine one per cent as local anesthesia before the biopsy procedure.
Patients who received GTN gave a significantly lower rating of pain due to probe insertion on a ten-point visual analogue scale (1.94) compared to those given placebo (3.24).
Pain perception for the whole procedure was lower in the active treatment group (2.13 versus 4.61), particularly for men aged less than 60 years.
Ten per cent of the GTN group reported headache, which was relieved with simple analgesia before they left the facility.
Summing up, the researchers conclude that topical GTN is safe and effective and "might be of maximum benefit in the younger patient and those having a repeat biopsy who previously failed to tolerate the procedure well.
