{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T00:40:45Z","timestamp":1776300045435,"version":"3.50.1"},"reference-count":30,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2014,8,21]],"date-time":"2014-08-21T00:00:00Z","timestamp":1408579200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int J of Urology"],"published-print":{"date-parts":[[2015,1]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To evaluate the efficacy and safety of combined intrarectal local analgesia and periprostatic nerve block versus periprostatic nerve block alone for pain control during transrectal ultrasound\u2010guided prostate biopsy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We comprehensively searched <jats:styled-content style=\"fixed-case\">P<\/jats:styled-content>ub<jats:styled-content style=\"fixed-case\">M<\/jats:styled-content>ed, <jats:styled-content style=\"fixed-case\">E<\/jats:styled-content>mbase and the <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>ochrane <jats:styled-content style=\"fixed-case\">L<\/jats:styled-content>ibrary trials. Studies comparing the two techniques were identified and pooled for cumulative analysis. The outcome measurements included visual pain scales of three consecutive procedures of transrectal ultrasound\u2010guided prostate biopsy, as well as short\u2010term postoperative complication rates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 18 studies that were finally eligible for the quantitative analysis involving 2076 participants. Combined modalities significantly reduced the pain associated with probe manipulation (weighted mean difference \u22122.06, 95% confidence interval \u22122.77 to \u22121.35, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), anesthesia infiltration (weighted mean difference \u22121.45, 95% confidence interval \u22122.20 to \u22120.70, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) and needle biopsy (weighted mean difference \u22120.55, 95% confidence interval \u22120.76 to \u22120.34, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). Subgroup analyses assessing different local analgesics showed that local anesthetics are generally more effective than myorelaxant and non\u2010steroidal anti\u2010inflammatory drugs. Lidocaine\u2010prilocaine cream proved the most effective in pain control regardless of the origin of pain. No significant difference of short\u2010term postoperative complications (fever, dysuria, acute urinary retention, hematuria, hematospermia and rectal bleeding) was found between the two techniques. The only side\u2010effect associated with local analgesics was headache reported in studies using glyceryl trinitrate ointment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Combined modalities show better analgesic efficacy than periprostatic nerve block alone for transrectal ultrasound\u2010guided prostate biopsy without increased morbidities. Among the various local analgesics, lidocaine\u2010prilocaine cream seems to offer the best overall efficacy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/iju.12595","type":"journal-article","created":{"date-parts":[[2014,8,21]],"date-time":"2014-08-21T09:39:17Z","timestamp":1408613957000},"page":"62-68","source":"Crossref","is-referenced-by-count":17,"title":["Addition of intrarectal local analgesia to periprostatic nerve block improves pain control for transrectal ultrasonography\u2010guided prostate biopsy: A systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"22","author":[{"given":"Jue","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Urology First Affiliated Hospital of Medical College of Xi'an Jiaotong University  Xi'an"},{"name":"Department of Urology Panzhihua Central Hospital  Panzhihua China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lei","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Urology First Affiliated Hospital of Medical College of Xi'an Jiaotong University  Xi'an"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yiqing","family":"Du","sequence":"additional","affiliation":[{"name":"Department of Urology First Affiliated Hospital of Medical College of Xi'an Jiaotong University  Xi'an"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dalin","family":"He","sequence":"additional","affiliation":[{"name":"Department of Urology First Affiliated Hospital of Medical College of Xi'an Jiaotong University  Xi'an"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xingfa","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Urology First Affiliated Hospital of Medical College of Xi'an Jiaotong University  Xi'an"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lei","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Urology First Affiliated Hospital of Medical College of Xi'an Jiaotong University  Xi'an"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xunyi","family":"Nan","sequence":"additional","affiliation":[{"name":"Department of Urology First Affiliated Hospital of Medical College of Xi'an Jiaotong University  Xi'an"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jinhai","family":"Fan","sequence":"additional","affiliation":[{"name":"Department of Urology First Affiliated Hospital of Medical College of Xi'an Jiaotong University  Xi'an"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,8,21]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ju.0000181212.51025.06"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(01)66464-4"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2012.09.033"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ju.0000131601.06286.26"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2006.12.005"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.2007.06990.x"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11255-009-9621-2"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b2700"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.283.15.2008"},{"key":"e_1_2_8_11_1","first-page":"1051","article-title":"The effects of combination of intrarectal lidocaine\u2010gel with periprostatic lidocaine injection on the pain relief in repeated transrectal prostate biopsy","volume":"46","author":"Park SM","year":"2005","journal-title":"Korean J. 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