OBJECTIVE: To compare the efficacy of periprostatic nerve block (PPNB) alone versus periprostatic nerve block plus oral Tramadol+Paracetamol Tablet for pain control during and after transrectal ultrasound-guided (TRUS) biopsy of the prostate gland. METHODS: This was a double-blind, placebo-controlled randomized clinical trial. The authors randomized 40 male patients each to either PPNB or PPNB plus oral tramadol and paracetamol (37.5mg/325mg) an hour prior to prostate biopsy. A ten-point visual analog scale was used to measure pain intensity and was recorded upon insertion of the ultrasound probe, during the biopsy, and one hour after the procedure. RESULTS: The two groups were similar in terms of baseline characteristics. Reductions in pain scores were statistically significantly different (p<.001) for each group when comparing pain from at point of insertion of the probe versus during biopsy and versus one-hour post-operatively. However, when comparing the two groups, the pain scores were not statistically significantly different upon insertion of the probe (p=.68), during the biopsy (p=.26) and one-hour post-operatively (p=.54). CONCLUSION Tramadol and paracetamol combination in addition to periprostatic nerve block produces pain relief similar to standard periprostatic nerve block alone.
Male ; Prostate ; Nerve Block ; Biopsy ; Ultrasonography

Metastatic calcinosis cutis of the penis and scrotum seen in a patient with End Stage Renal Disease (ESRD) on hemodialysis is a case not usually encounter in urology clinics. Review of the available literature mostly showed compromised erectile function of patients with metastatic calcinosis cutis of the penis. Presented is a case of a patient with ESRD on hemodialysis for five years who developed metastatic calcinosis of the penis and scrotum causing dysmorphic changes, however maintaining full erectile function. Preserving the erectile function after successful excision of the penile and scrotal calcification is imperative to maintain good quality of life.
Erectile Dysfunction ; Hyperparathyroidism, Secondary