Fourteen RCTs (n=1,583) were included.
Five studies reported the randomisation method. Four studies used double-blinding, three used single or partial blinding, and seven did not use blinding. Five studies did not report both inclusion and exclusion criteria. One study reported a sample size calculation.
Patients receiving periprostatic local anaesthetic reported significantly reduced pain compared with the control group (SMD -1.05, 95% CI: -1.40, -0.71, p<0.001). Significant statistical heterogeneity was found (p<0.001; tau-square 0.35, p<0.001).
There was no evidence of publication bias (funnel plot was symmetrical; Begg’s test p=0.29; Egger’s test p=0.71).
The sensitivity analysis showed slight changes in treatment effect size when studies were sequentially omitted, but the results remained statistically significant in favour of periprostatic local anaesthetic.
Subgroup analyses showed similar statistically significant results compared with the main analysis.