OBJECTIVES: To quantify the degree of pain experienced by patients who undergo ultrasound-guided transrectal prostate biopsy in standard clinical practice and assess the clinical factors associated with increased pain.
MATERIAL AND METHODS: Analysis of a multicenter series of patients with prostate biopsy according to standard clinical practice. The biopsy was performed transrectally with a protocol of local anesthesia on the posterolateral nerve bundle. The pain was assessed at 20 minutes into the procedure using the visual analog scale (0-10). The degree of pain was analyzed, and the association was studied using a univariate/multivariate analysis of selected clinical variables and the degree of pain.
RESULTS: A total of 1188 patients with a median age of 64 years were analyzed. Thirty percent of the biopsies were diagnosed with a tumor. The median pain score was 2, with 65% of the patients reporting a pain score ≤ 2. The multivariate analysis showed that the prostate volume (RR, 1.34; 95% CI 1.01-1.77; P=.04), having a previous biopsy (RR, 2.25; 95% CI 1.44-3.52; P< .01), age (RR, .63; 95% CI .47-.85; P< .01) and feel palpation (RR, 1.95; 95% CI 1.28-2.96; P< .01) were factors independently associated with greater pain during the procedure.
CONCLUSIONS: Transrectal biopsy with local anesthesia is a relatively painless technique. Factors such as age, a previous biopsy, pain on being touched and prostate volume were associated with the presence of greater pain during the procedure.
Written by:
Gómez-Gómez E, Ramírez M, Gómez-Ferrer A, Rubio-Briones J, Iborra I, J Carrasco-Valiente, Campos JP, Ruiz-García J, Requena-Tapia MJ, Solsona E. Are you the author?
Servicio de Urología, IMIBIC, Hospital Universitario Reina Sofía, Universidad de Córdoba, Córdoba, España; Servicio de Urología, Instituto Valenciano de Oncología, Valencia, España.
Reference: Actas Urol Esp. 2015 Mar 6. pii: S0210-4806(15)00030-3.
doi: 10.1016/j.acuro.2015.01.007
PubMed Abstract
PMID: 25745791
Article in English, Spanish.