• Bora Irer, Aytac Gulcu, Guven Aslan, Yigit Goktay, and Ilhan Celebi.
• Department of Urology, Dokuz Eylul University School of Medicine, Izmir, Turkey.
• Urology. 2005 Oct 1; 66 (4): 799-802.

ObjectivesTo evaluate the additional analgesic efficacy of the rectal administration of diclofenac suppository compared with placebo in patients undergoing transrectal ultrasound-guided prostate biopsy.MethodsA total of 40 consecutive men undergoing biopsy were enrolled in this study. Patients were randomized equally into two treatment groups. In group 1, patients received an intrarectal 100-mg diclofenac suppository 1 hour before biopsy. In group 2, patients received a glycerin suppository as a placebo intrarectally 1 hour before biopsy. All patients received 10 mL of 2% lidocaine gel intrarectally 10 minutes before biopsy. A self-administrated visual analog scale was used to measure the pain scores at the end of the biopsy and 2 hours and 1 day after the biopsy.ResultsThe mean patient age was 63.3 +/- 6.8 years and 61.6 +/- 6.7 years in groups 1 and 2, respectively. The mean pain score in groups 1 and 2 was 3.4 +/- 1.3 versus 5.9 +/- 1.7 (P < 0.0001), respectively, at the end of the biopsy. The mean pain score at 2 hours and 1 day after the procedure was 1.2 +/- 1.0 versus 3.6 +/- 1.4 (P < 0.0001) and 0.5 +/- 0.9 versus 1.4 +/- 1.3 (P = 0.017) in groups 1 and 2, respectively.ConclusionsIntrarectal diclofenac suppository administration is a simple, safe, and effective procedure to reduce pain and improve patients' tolerance of transrectal ultrasound-guided prostate biopsy. We recommend intrarectal diclofenac suppository administration, together with intrarectally administered lidocaine gel, in men undergoing transrectal ultrasound-guided prostate biopsy.

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