Which Technical Aspects have an Impact on Perceived Pain during Transperineal Prostate Biopsy? A Prospective Study Involving 445 Cases (original) (raw)
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The European Research Journal, 2020
Objectives: To evaluate the risk factors for pain occurring during prostate biopsy. Methods: This study included 123 patients were applied with prostate needle biopsy under transrectal ultrasonography. The patients were randomly separated into 3 groups of 41 individuals. For periprostatic nerve blockage, 10 cc 2% lidocaine was applied to Group 1, 10 cc 0.25% levobupivacaine to Group 2, and 10 cc 0.25% bupivacaine to Group 3. A 10 cm Visual Analogue Scale (VAS) was used to evaluate patient pain. The pain of the patients was evaluated in 4 stages. VAS 1: Pain score during the injection of the anaesthetic agent; VAS 2: Pain score during the biopsy when half the procedure was completed; VAS 3: Pain score following removal of the rectal probe immediately after the biopsy; and VAS 4: Pain score at 1 hour after the biopsy. Results: There were significant negative correlations between VAS 3 pain scores and age in group 1, group 3 and for entire cohort (p = 0.013, p = 0.031 and p = 0.033, re...
International Urology and Nephrology, 2008
Introduction To find the most beneficial method, we assessed patient comfort and morbidity rates during prostate biopsy procedures performed using periprostatic nerve blockade, unilateral pudendal nerve blockade, intrarectal lidocaine gel, and a combination of periprostatic nerve blockade and intrarectal lidocaine gel. Materials and methods A total of 159 patients were included in this study. Pain evaluation results were retrospectively assessed and retrieved from the patient charts. Patients in group 1 (n = 64) received no anesthesia, group 2 (n = 34) received periprostatic nerve blockade, group 3 (n = 26) received unilateral pudendal nerve blockade, group 4 (n = 20) received intrarectal lidocaine gel, and group 5 (n = 15) received a combination of periprostatic nerve blockade and intrarectal lidocaine gel. A visual analog scale (VAS) was used for pain evaluations. Results According to pain scores (VAS) during probe insertion, only group 2 did not show a statistically significant difference (P > 0.05), while the other groups were found to be significantly different when compared to group 1. Groups 2, 3, and 5 were found to be significantly different when compared to group 1 according to pain scores (VAS) during insertion of needles. Groups 3 and 5 displayed statistically significant differences when compared to group 1 as regards pain scores during both the insertion of the probe and biopsy. Conclusions Our data suggests that using either a combination of intrarectal lidocaine gel and periprostatic block or solely unilateral pudendal nerve block for prostate biopsy procedures provides efficient patient comfort by reducing pain both during probe insertion and needle passing through the prostate gland.
Scandinavian Journal of Urology and Nephrology, 2010
Objective. To evaluate the pain score during transrectal ultrasound (TRUS)-guided prostate biopsy using three different anaesthetic applications and no anaesthesia. Material and methods. One-hundred men undergoing TRUS-guided prostate biopsy were prospectively enrolled in this study. Patients were randomized to four groups. Group 1 (n = 25) received no anaesthesia, group 2 (n = 25) was administered a perianal lidocaine injection, group 3 (n = 25) was administered a periprostatic lidocaine injection, and group 4 (n = 25) was administered a combination of perianal-intrarectal lidocaine-prilocaine cream. The anaesthetic application was given 5 min before the procedure. All patients were asked to indicate the level of pain experienced on a visual analogue scale (VAS) during three situations, including when the TRUS probe was inserted and 15 min and 2 weeks after biopsy. Results. Mean pain scores were similar in all groups at the time of probe insertion. Mean pain scores showed statistically significant differences between group 1 and the other groups, except for group 4, 15 min after the procedure. Group 3 showed better pain control 15 min after biopsy and this difference was statistically significant (p < 0.043). The VAS scores were similar 2 weeks after the procedure in all groups. Conclusions. Anaesthetic application before TRUSguided prostate biopsy may be advocated. The application of periprostatic lidocaine seems to be the most advantageous method for lowering the perception of pain.
2007
Objective: Transrectal ultrasound (TRUS) guided prostate biopsy is well tolerated by patients but the lack of an effective marker to predict pain prevents us from determining pre-procedurally which patient group needs local anesthesia for biopsy and probe pain. Thus in this study, we investigated predictor factors for prostate biopsy and probe insertion pain. Materials and Methods: 71 patients who were undergoing prostate biopsy without anesthesia were included in the study retrospectively. Pain had been assessed with visual analogue scale (VAS 0-10). Digital rectal examination (DRE) pain was analyzed for biopsy and probe insertion pain. Results: DRE pain was related to both probe pain and biopsy pain. Conclusion: Although level of pain during DRE determines patients in need of local anesthesia, since the number of patients with moderate-severe pain is rather big, it seems efficient in determining the patients in need of additional anesthesia due to probe pain.
Journal of Urological Surgery, 2018
Objective: To evaluate the effects of three different local anesthetic agents in patients who underwent Transrectal ultrasoun guided prostate needle biopsy. Materials and Methods: One hundred and sixty patients who were admitted to our clinic between January 2012 and May 2012 for prostate biopsy were divided into 4 groups: no anesthesia-administered group (group 1), lidocaine-administered group (group 2), levobupivacaine-administered group (group 3) and bupivacaine-administered group (group 4). Pain intensity was evaluated in each group using the visual analog scale (VAS): during administration of local anesthetic (VAS 1), during the biopsy (VAS 2), just after the biopsy (VAS 3) and one hour after the biopsy (VAS 4). Results: There was not any significant difference among the groups in terms of VAS 1 (p=0.152). Pain scores were significantly lower during biopsy (VAS 2) in groups 1, 2 and 3 compared to that in group 1 (p=0.001, p=0.005 and p=0.007, respectively). VAS 3 scores were significantly lower in group 2 and group 3 compared to group 1 while no difference was found in group 4 (p=0.003, p=0.032, and p=0.136, respectively). VAS 4 scores were significantly lower only in group 3 compared to group 1 (p=0.001). Conclusions: It was observed that all the three local anesthetics effectively diminished pain during prostate biopsy. However, we found that levobupivacaine, which improved pain scores in all steps of pain evaluation compared to the control group, was relatively superior for pain management in the transrectal biopsy setting.
2020
PURPOSE To evaluate the efficacy of caudal regional anesthesia and local anesthesia methods in prostate biopsy applied under transrectal ultrasonography.Matherials and Methods: This prospective study included a total of 160 patients randomly separated into 4 equal groups as intrarectal local anesthesia (IRLA), periprostatic local anesthesia (PPLA), combined local anesthesia (IRLA+PPLA), and caudal regional anesthesia (CRA). The patients were evaluated using the pain scores on a visual analog scale. RESULTS The pain score during anesthesia induction was significantly higher in the CRA group than in the IRLA and IRLA+PPLA groups (p<0.001). The pain score during entry of the probe to the rectum and movement was significantly lower in the CRA group than the IRLA groups (p=0.014). The pain score on penetration of the needle to the prostate and at 30 mins after the biopsy was significantly higher in the IRLA group (p<0.001). At 2 hours after the biopsy, the pain score in the CRA gro...
Relationship between Complications due to Prostate Biopsy and the Scores of Pain and Discomfort
Urologia Internationalis, 2004
Introduction: Transrectal ultrasound (TRUS)-guided prostate biopsy is routinely performed in the prostatespecific antigen era. In this study, we evaluated morbidity and complications observed in patients undergoing TRUS-guided prostate biopsy following intrarectal lidocaine application and the relation of these complications to pain and discomfort. Patients and Methods: Between January 2000 and August 2002, a total of 128 patients underwent TRUS-guided prostate biopsy. The procedure was carried out following an intrarectal application of 10 cm 3 2% lidocaine gel. Immediately after the biopsy, pain and discomfort scores were determined using a 10point linear visual analog scale. The patients were seen 10 days later and questioned for complications. Results: At least one complication was observed in 107 patients (84%). Most frequent complications were macroscopic hematuria (90%), hematochezia (36%), and hematospermia (13%). The mean pain and discomfort scores of the patients were found to be correlated to each other (p ! 0.01). The complication-negative group had significantly lower pain and discomfort scores (p ! 0.01). The scores of the patients with hematochezia were significantly higher than the scores of the patients with other complications (p ! 0.01). Conclusions: Minor complications like hematuria, hematochezia, and hematospermia are frequently seen in patients undergoing TRUS-guided prostate biopsies. The pain and discomfort scores may be predictors of minor complications, particularly of rectal bleeding.
Transrectal ultrasound (TRUS) guided prostate biopsy: Three different types of local anesthesia
Archivio italiano di urologia, andrologia : organo ufficiale [di] Societa italiana di ecografia urologica e nefrologica, 2016
Transrectal Ultrasound (TRUS) guided prostate biopsy is regarded as the gold standard for prostate cancer diagnosis. The majority of patients perceive TRUS-guided prostate biopsy as a physically and psychologically traumatic experience. We aimed to compare in this paper the efficacy of three different anesthesia techniques to control the pain during the procedure. 150 patients who underwent transrectal ultrasound (TRUS) guided prostate biopsy were randomly divided into three groups. Group A included 50 patients who received one hour before the procedure a mixture of 2.5% lidocaine and 2.5% prilocaine, Group B: 50 patients who received intrarectal local anesthetic administration (lidocaine 5 ml 10%) and lidocaine local spray 15 % and Group C included 50 patients who received periprostatic block anesthesia (lidocaine 10 ml 10%). Visual analogue scale (VAS) of patients in different groups was evaluated at the end of the biopsy and 30 minutes after the procedure. The VAS of patients in ...