Effect of patient position on pain scales during transrectal ultrasound-guided prostate biopsy

PURPOSE - Transrectal ultrasound (TRUS)-guided prostate biopsy is the most useful technique for the diagnosis of prostate cancer; however, many patients describe the procedure as uncomfortable and painful. We investigated the effect of the patient's position on pain scales during TRUS-guided prostate biopsy.

MATERIALS AND METHODS - Between July 2012 and June 2013, a total of 128 consecutive patients who underwent TRUS-guided prostate biopsy were included in this study. Seventy patients underwent the procedure in the lithotomy position performed by a urologist and the other patients (n=58) underwent the procedure in the left lateral decubitus (LLD) position performed by a radiologist. Pain was assessed by using visual analogue scale (VAS) scores from 0 to 10. Using a linear regression model, we analyzed the correlation between pain scale score and clinical variables with a focus on patient position.

RESULTS - No significant differences related to age, body mass index, prostate volume, prostate-specific antigen (PSA), hematuria, pyuria, International Prostate Symptom Score, or the cancer detection rate were observed between the lithotomy and the LLD groups. In the correlation analysis, VAS score showed a significant correlation with diabetes mellitus, PSA level, and lithotomy position (p<0.05). In the multiple linear regression model, VAS score showed a significant correlation with lithotomy position (β=-0.772, p=0.003) and diabetes mellitus (β=-0.803, p=0.033).

CONCLUSIONS - We suggest that the lithotomy position may be the proper way to reduce pain during TRUS-guided prostate biopsy.

Korean J Urol. 2015 Jun;56(6):449-54. doi: 10.4111/kju.2015.56.6.449. Epub 2015 Jun 1.

Kim YU1, Ji YS1, Ko YH1, Song PH1.

Department of Urology, Yeungnam University College of Medicine, Daegu, Korea.