Year 2020, Volume 6 , Issue 5, Pages 470 - 478 2020-09-04

Should anaesthesia method for prostate biopsy be the same for every patient? A randomised prospective study to determine the risk factors for pain

Sinan AVCI [1] , Sedat ONER [2] , Efe ÖNEN [3] , Volkan ÇAĞLAYAN [4] , Metin KILIÇ [5] , Murat ŞAMBEL [6]


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, respectively). In group 1 both total and free PSA showed significant negative correlations with VAS 3 pain scores (p = 0.020 and p = 0.010, respectively). In group 2 VAS 4 pain scores of the patients with suspicious digital examination findings were found to be significantly higher than those of the patients with benign digital examination findings (p = 0.025).

Conclusions: Of all patients to be applied with prostate biopsy, those of a younger age, with a lower PSA level, with suspicious digital rectal examination findings constitute a relatively higher risk group in respect of pain. 

biopsy, pain, prostate, risk factors
  • 1. Rietbergen JB, Kruger AEB, Kranse R, Schröder FH. Complications of transrectal ultrasound-guided systematic sextant biopsies of the prostate: evaluation of complication rates and risk factors within a population-based screening program. Urology 1997;49:875-80.
  • 2. Collins GN, Lloyd SN, Hehir M, McKelvie GB. Multiple transrectal ultrasound‐guided prostatic biopsies - true morbidity and patient acceptance. Br J Urol 1993;71:460-3.
  • 3. Clements R, Aideyan OU, Griffiths GJ, Peeling WB. Side effects and patient acceptability of transrectal biopsy of the prostate. Clin Radiol 1993;47:125-6.
  • 4. Djavan BOB, Waldert M, Zlotta A, Dobronski P, Seitz C, Remzi M, et al. Safety and morbidity of first and repeat transrectal ultrasound guided prostate needle biopsies: results of a prospective European prostate cancer detection study. J Urol 2001;166:856-60.
  • 5. Chang SS, Alberts G, Wells N, Smith JR, Cookson MS. Intrarectal lidocaine during transrectal prostate biopsy: results of a prospective double-blind randomized trial. J Urol 2001;166:2178-80.
  • 6. Philip J, Mccabe JE, Dutta Roy S, Samsudin A, Campbell IA, Javle P. Site of local anaesthesia in transrectal ultrasonography‐guided 12‐core prostate biopsy: does it make a difference? BJU Inter 2006;97:263-5.
  • 7. Raaijmakers R, Kirkels WJ, Roobol MJ, Wildhagen MF, Schrder FH. Complication rates and risk factors of 5802 transrectal ultrasound-guided sextant biopsies of the prostate within a population-based screening program. Urology 2002; 60:826-30.
  • 8. Peyromaure M, Ravery V, Messas A, Toublanc M, Boccon-Gibod L, Boccon-Gibod L. Pain and morbidity of an extensive prostate 10-biopsy protocol: a prospective study in 289 patients. J Urol 2002;167:218-21.
  • 9. Zisman A, Leibovici DAN, Kleinmann J, Siegel YI, Lindner A. The impact of prostate biopsy on patient well-being: A prospective study of pain, anxiety and erectile dysfunction. J Urol 2001;165:445-54.
  • 10. Hossack T, Woo HH. Acceptance of repeat transrectal ultrasonography guided prostate biopsies with local anaesthesia. BJU Int 2011;107:38-42.
  • 11. Inal G, Yazici S, Adsan O, Ozturk B, Kosan M, Cetinkaya M. Effect of periprostatic nerve blockade before transrectal ultrasound‐guided prostate biopsy on patient comfort: A randomized placebo controlled study. Int J Urol 2004;11:148-51.
  • 12. Bastide C, Lechevallier E, Eghazarian C, Ortega JC, Coulange C. Tolerance of pain during transrectal ultrasound-guided biopsy of the prostate: risk factors. Prostate Cancer Prostatic Dis 2003;6:239-41.
  • 13. Yun TJ, Lee J, Kim SH, Lee SE, Byun SS, Hong SK, et al. Prospective analysis on the relation between pain and prostate volume during transrectal prostate biopsy. Korean J Radiol 2007;8:231-5.
  • 14. Rodriguez LV, Terris MK. Risks and complications of transrectal ultrasound guided prostate needle biopsy: A prospective study and review of the literature. J Urol 1998;60:2115-20.
  • 15. Kaygisiz O, Inal G, Tas M, Ugurlu O, Oztur B, Adsan O. Can pain during digital rectal examination help us to decide the necessity and the method of anesthesia for transrectal ultrasound guided prostate needle biopsy?. Int Braz J Urol 2007; 33:470-6.
  • 16. Saraçoğlu T, Unsal A, Taşkın F, Sevinçok L, Karaman CZ. The impact of pre-procedural waiting period and anxiety level on pain perception in patients undergoing transrectal ultrasound-guided prostate biopsy. Diagn Interv Radiol 2012;18:195-9.
Primary Language en
Subjects Urology ve Nephrology
Journal Section Original Articles
Authors

Orcid: 0000-0002-3354-5352
Author: Sinan AVCI (Primary Author)
Institution: Department of Urology, University of Health Sciences, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey
Country: Turkey


Orcid: 0000-0003-3495-2619
Author: Sedat ONER
Institution: Department of Urology, University of Health Sciences, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey
Country: Turkey


Orcid: 0000-0001-9898-7808
Author: Efe ÖNEN
Institution: Department of Urology, University of Health Sciences, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey
Country: Turkey


Orcid: 0000-0001-9303-9585
Author: Volkan ÇAĞLAYAN
Institution: Department of Urology, University of Health Sciences, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey
Country: Turkey


Orcid: 0000-0003-4255-731X
Author: Metin KILIÇ
Institution: Department of Urology, University of Health Sciences, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey
Country: Turkey


Orcid: 0000-0002-3069-7078
Author: Murat ŞAMBEL
Institution: Department of Urology, University of Health Sciences, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey
Country: Turkey


Dates

Application Date : January 30, 2019
Acceptance Date : August 2, 2019
Publication Date : September 4, 2020

EndNote %0 The European Research Journal Should anaesthesia method for prostate biopsy be the same for every patient? A randomised prospective study to determine the risk factors for pain %A Sinan Avcı , Sedat Oner , Efe Önen , Volkan Çağlayan , Metin Kılıç , Murat Şambel %T Should anaesthesia method for prostate biopsy be the same for every patient? A randomised prospective study to determine the risk factors for pain %D 2020 %J The European Research Journal %P -2149-3189 %V 6 %N 5 %R doi: 10.18621/eurj.519668 %U 10.18621/eurj.519668