The 3 groups were similar in age, body mass index, serum prostate specific antigen and total prostate volume. There was no significant difference in pain scores during probe insertion, local anesthetic injection, and transrectal ultrasonography between three groups. Pain during prostate biopsy was significantly lower in group 1 and 2 than group 3. There was no significant difference during prostate biopsy between group 1 and 2. The mean pain score during biopsy was no significant difference between the mean pain scores, 30 minutes after biopsy among three groups. There were no major complications. CONCLUSIONS: PPB under Doppler ultrasound guidance does not improve patient pain during biopsy compared with PNB.

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Low-dose rate brachytherapy has become a mainstream treatment option for men diagnosed with prostate cancer because of excellent long-term treatment outcomes in low-, intermediate-, and high-risk patients. Largely due to patient lead advocacy for minimally invasive treatment options, high-quality prostate implants have become widely available in the US, Europe, and Japan. The reason that brachytherapy results are reproducible in several different practice settings is because numerous implant quality factors have been defined over the last 20 years, which can be applied objectively to judge the success of the intervention both during and after the procedure. In addition, recent long-term follow-up studies have clarified that the secondary cancer incidence of brachytherapy is not clinically meaningful. In terms of future directions, the study of radiation repair genetics may allow for the counseling physician to better estimate any given patients risk for side effects, thereby substantially reducing the therapeutic uncertainties faced by patients choosing a prostate cancer intervention.

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