A randomized controlled comparison between periprostatic nerve block and pelvic plexus block at the base and apex of 14-core prostate biopsies

Kim, Sung Jin; Lee, Jongpill; An, Dong Hyeon; Park, Chang-Hoo; Lim, Jun Woo; Kim, Han Gwun; Park, Jong Yeon

doi:10.1007/s00345-019-02722-w

Cited by 9 publications

(13 citation statements)

References 26 publications

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“…Two studies ( 17 , 19 ) compared the pain control for patients’ prostate volume less than 40 ml between these two groups. There was no statistical difference for the pain control during biopsy between PPB and PNB.…”

Section: Resultsmentioning

confidence: 99%

“…By removing duplicates, reviews, and articles that were not relevant to the question, 11 articles were remained. Then, after full-text screening of these articles, six articles (12,(15)(16)(17)(18)(19) were assessed for eligibility. Further evaluations and detailed analysis of the articles were shown in Figure 1.…”

Section: Eligible Studiesmentioning

confidence: 99%

“…Six studies compared the pain control of biopsy between PPB and PNB, respectively. Among these studies, Sung Jin Kim et al (19) compared the VAS score in different biopsy sites. The pooled MD results demonstrated that compared with PNB, PPB was associated with a significant decrease in pain(pooled MD = −0.57, 95% CI: −1.11 to −0.03, Z = 2.06, P = 0.04, Figure 4).…”

Section: During Biopsymentioning

confidence: 99%

“…Five studies (12,15,(17)(18)(19) and one study (16) reported transrectal and transperineal prostate biopsy, respectively. The pooled results showed that compared with PNB, PPB patients experienced less pain during biopsy, regardless of transrectal or transperineal approach (Table 2).…”

Section: Biopsy Approachmentioning

confidence: 99%

“…However, previous meta-analyses (13,14) only have included two studies and the number of cases is relatively small, and only VAS scores were compared, no complications were compared. In the past few years, more prospective randomized controlled trials (RCTs) comparing PPB and PNB drew conflicting conclusions (12,(15)(16)(17)(18)(19). Thus, in order to get more reliable evidence to guide clinical practice, a meta-analysis is necessary to determine whether PPB is superior to PNB for pain control during ultrasoundguided prostate biopsy.…”

Section: Introductionmentioning

confidence: 99%

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Pelvic Plexus Block Versus Periprostatic Nerve Block for Ultrasound-Guided Prostate Biopsy: A Meta-Analysis

Ding¹,

Ning²,

Ma³

2021

Front. Oncol.

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BackgroundTo relieve prostate biopsy-related pain, various local anesthetic methods have been used. The best approach was periprostatic nerve block (PNB) in the past decade. Recently, pelvic plexus block (PPB) was employed to ultrasound-guided prostate biopsy. Compared with the PNB, the PPB may block a more extensive area. Therefore, PPB may be more effective in relieving prostate biopsy-related pain. However, several prospective randomized controlled trials (RCTs) comparing PPB and PNB drew conflicting conclusions, so we compared the difference of pain control between PPB and PNB for prostate biopsy.MethodsThe following databases were retrieved up to October 2020: PubMed, Chinese biomedicine literature database, the Cochrane Library, China National Knowledge Internet databases, Wan fang databases and Google Scholar. Only the RCTs were included. The main outcome measures were Visual Analog Scale (VAS) score and complications. The literature quality and extracted data were evaluated by two authors independently. The software Review Manager (version 5.3) was used to perform the data analysis that comparing the difference of VAS score and complications between PPB and PNB.ResultsAfter screening, six articles including 336 patients from PPB group and 337 patients from PNB group were performed meta-analysis in this study. The results showed that there were no significant difference of pain control in probe insertion and local anesthetic injection between PPB and PNB, while compared with PNB, patients with PPB experienced less pain during biopsy and 30 min after biopsy, respectively(MD = −0.57, 95% CI: −1.11 to −0.03, Z = 2.06, P = 0.04; MD = −0.21, 95% CI: −0.40 to −0.02, Z = 2.15, P = 0.03). In subgroup analysis, the pooled results showed that PPB was superior to PNB in 12-cores biopsy (pooled MD = −1.16, 95% CI: −1.61 to −0.71, P < 0.00001), and more than 40-ml prostate size, regardless of transrectal or transperineal prostate biopsy. The reported major complications were urinary retention, hematuria, infection and hemospermia. The pooled results showed that there were no obvious difference in complications between PPB group and PNB group.ConclusionsOverall, this meta-analysis suggests that PPB provides safe and effective pain control of ultrasound-guided prostate biopsy, and PPB is superior to PNB. In future, it also needs more high quality, large samples RCTs to verify.

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Section: Resultsmentioning

confidence: 99%

Section: Eligible Studiesmentioning

confidence: 99%

Section: During Biopsymentioning

confidence: 99%

Section: Biopsy Approachmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Pelvic Plexus Block Versus Periprostatic Nerve Block for Ultrasound-Guided Prostate Biopsy: A Meta-Analysis

Ding¹,

Ning²,

Ma³

2021

Front. Oncol.

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Can a nomogram predict apical prostate cancer pathology upgrade from fusion biopsy to final pathology? A multicenter study

Feng,

Liang,

Xiao

et al. 2024

Cancer Medicine

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BackgroundThis study evaluates the efficacy of a nomogram for predicting the pathology upgrade of apical prostate cancer (PCa).MethodsA total of 754 eligible patients were diagnosed with apical PCa through combined systematic and magnetic resonance imaging (MRI)‐targeted prostate biopsy followed by radical prostatectomy (RP) were retrospectively identified from two hospitals (training: 754, internal validation: 182, internal–external validation: 148). A nomogram for the identification of apical tumors in high‐risk pathology upgrades through comparing the results of biopsy and RP was established incorporating statistically significant risk factors based on univariable and multivariable logistic regression. The nomogram's performance was assessed via the receiver operating characteristic (ROC) curve, calibration plots, and decision curve analysis (DCA).ResultsUnivariable and multivariable analysis identified age, targeted biopsy, number of targeted cores, TNM stage, and the prostate imaging‐reporting and data system score as significant predictors of apical tumor pathological progression. Our nomogram, based on these variables, demonstrated ROC curves for pathology upgrade with values of 0.883 (95% CI, 0.847–0.929), 0.865 (95% CI, 0.790–0.945), and 0.840 (95% CI, 0.742–0.904) for the training, internal validation and internal–external validation cohorts respectively. Calibration curves showed good consistency between the predicted and actual outcomes. The validation groups also showed great generalizability with the calibration curves. DCA results also demonstrated excellent performance for our nomogram with positive benefit across a threshold probability range of 0–0.9 for the training and internal validation group, and 0–0.6 for the internal–external validation group.ConclusionThe nomogram, integrating clinical, radiological, and pathological data, effectively predicts the risk of pathology upgrade in apical PCa tumors. It holds significant potential to guide clinicians in optimizing the surgical management of these patients.

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Pain control according to the periprostatic nerve block site in magnetic resonance imaging/transrectal targeted prostate biopsy

Yoo

Koo

Chung

et al. 2022

Sci Rep

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We analyzed the intensity of pain at each site of systemic prostate biopsy (SBx) and compared the intensity of pain among magnetic resonance (MRI)-targeted transrectal biopsies according to the periprostatic nerve block (PNB) site. We collected data from 229 consecutive patients who had undergone MRI-targeted biopsy. Patients were stratified into two groups according to the site of PNB (base versus base and apex PNB). Pain was quantified at the following time points: probe insertion, injection at the prostate base, injection at the prostate apex, MRI cognitive biopsy (CBx), MRI/transrectal ultrasound fusion biopsy (FBx), SBx, and 15 min after biopsy. For all biopsy methods, the average pain were significantly higher in the base PNB group than in the base and apex PNB group (CBx, p < 0.001; FBx, p = 0.015; SBx, p < 0.001). In the base and apex PNB group, FBx was significantly more painful than SBx (p = 0.024). Overall, regardless of the PNB site, pain at the anterior sites was more than that at the posterior sites in FBx (p = 0.039). Base and apex PNB provided better overall pain control than base-only PNB in all biopsy methods. In the base and apex PNB group, FBx was more painful than CBx and SBx.

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A randomized controlled comparison between periprostatic nerve block and pelvic plexus block at the base and apex of 14-core prostate biopsies

Cited by 9 publications

References 26 publications

Pelvic Plexus Block Versus Periprostatic Nerve Block for Ultrasound-Guided Prostate Biopsy: A Meta-Analysis

Pelvic Plexus Block Versus Periprostatic Nerve Block for Ultrasound-Guided Prostate Biopsy: A Meta-Analysis

Can a nomogram predict apical prostate cancer pathology upgrade from fusion biopsy to final pathology? A multicenter study

Pain control according to the periprostatic nerve block site in magnetic resonance imaging/transrectal targeted prostate biopsy

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