Pain assessment after original transperineal prostate biopsy using a coaxial needle

Novella, Giovanni; Ficarra, Vincenzo; Galfano, Antonio; Ballario, R; Novara, Giacomo; Cavalleri, Stefano; Artibani, Walter

doi:10.1016/s0090-4295(03)00483-7

Cited by 36 publications

(26 citation statements)

References 14 publications

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“…Novella and co-workers [11] used a coaxial transperineal needle during transperineal prostate biopsy to see whether it could reduce patients' pain. The authors found that the use of a coaxial transperineal needle decreased the overall invasiveness of the procedure.…”

Section: Discussionmentioning

confidence: 99%

Does needle calibre affect pain and complication rates in patients undergoing transperineal prostate biopsy? A prospective, randomized trial

Saredi¹,

Mc²,

Fidanza³

et al. 2009

Asian J Androl

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Transperineal prostate biopsy is a procedure that can be used to obtain histological samples from the prostate. To improve both the quality of the biopsy core samples and prostate cancer detection, we are currently performing a prospective, randomized trial comparing prostate biopsy samples obtained using an 18 G-needle to those obtained using a 16 G needle. The aim of this preliminary study was to evaluate pain and complication rates in both groups in order to assess whether performing a prostate biopsy with a larger calibre needle is a feasible procedure. One hundred and eighty-seven patients undergoing transperineal prostate biopsy were prospectively evaluated and divided into two groups. The first group (94 patients, Group A) received a transperineal prostate biopsy using a 16 G-needle and the second group (93 patients, Group B) underwent transperineal prostate biopsy with an 18 G-needle. Anaesthesia was obtained with a single perineal injection at the prostatic apex in all subjects. A visual analogue scale (VAS) and facial expression scale (FES) were used to assess pain during multiple steps of the procedure in each group. A detailed questionnaire was used to obtain information about drug use because it could potentially influence the pain and complications that patients experienced. Two weeks after the procedure, early and late complications were evaluated. Statistical analysis was carried out using non-parametric tests. Prostate Specific Antigen (PSA) and drug use were similar at baseline between the two groups. Pain during prostate biopsy, which was measured with both the VAS and FES instruments, did not differ significantly between the 18-and 16 G-needle groups, and no significant differences were found in early or late complication rates between the groups. Transperineal prostate biopsy with a 16 G-needle is a feasible procedure in terms of pain and complication rates. Further studies with larger patient populations are required to assess whether or not this procedure can improve prostate cancer detection rates.

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Section: Discussionmentioning

confidence: 99%

Does needle calibre affect pain and complication rates in patients undergoing transperineal prostate biopsy? A prospective, randomized trial

Saredi¹,

Mc²,

Fidanza³

et al. 2009

Asian J Androl

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show abstract

“…Concerning local anesthesia, both transrectal and transperineal FNASV need anesthesia at the apex of the prostate. The transperineal approach may simplify the anesthetic injection at the prostate apex (5). Because the use of a coaxial needle significantly reduced the pain experienced during prostate sampling and improved patient compliance compared with the conventional transperineal biopsy technique (5), it is possible to obtain similar results using this approach for FNASV.…”

Section: Discussionmentioning

confidence: 99%

“…The transperineal approach may simplify the anesthetic injection at the prostate apex (5). Because the use of a coaxial needle significantly reduced the pain experienced during prostate sampling and improved patient compliance compared with the conventional transperineal biopsy technique (5), it is possible to obtain similar results using this approach for FNASV. Because no data are currently available that make a direct comparison between the transperineal coaxial needle and the standard TRUS-guided biopsy, it is not possible to distin- guish which is better in terms of less pain and discomfort.…”

Section: Discussionmentioning

confidence: 99%

“…The needle was progressively retracted and 2 mL of anesthetic was administered along the needle path. Then, a coaxial 17-gauge TruGuide needle was placed, according to the previously described technique (5). All maneuvers were made under continuous ultrasound control.…”

Section: Case Reportmentioning

confidence: 99%

“…This minimally invasive approach made it possible to obtain seminal fluid with a sperm count of 40 million/mL and 2% motility, suitable for subsequent in vitro fertilization and resulting in a successful pregnancy (4). Those encouraging results led us to perform an FNASV in a young man with obstructive azoospermia, using our original transperineal approach with a coaxial needle (5), with the aim of assessing its feasibility as a sperm retrieval technique.…”

mentioning

confidence: 99%

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Use of transperineal fine needle aspiration of seminal vesicles to retrieve sperm in a man with obstructive azoospermia

Cerruto

Novella

Antoniolli

et al. 2006

Fertility and Sterility

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Prospective per‐target analysis of the added value of the PrecisionPoint Transperineal Access System in cognitive prostate biopsy of MRI targets

Orecchia,

Germani,

Colalillo

et al. 2024

BJUI Compass

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ObjectivesThe objective of this study is to evaluate the diagnostic performance of perineal access cannulas tethered to a biplanar ultrasound probe in cognitive transperineal prostate biopsies of targets identified by multiparametric magnetic resonance imaging (mpMRI) by comparing the results of the PrecisionPoint (PP) Transperineal Access System with the double‐freehand (DFH) technique.Patients and methodsAll patients who underwent cognitive transperineal prostate biopsy of mpMRI targets using the PP or DFH technique between November 2020 and September 2023 were enrolled. All data related to mpMRI target biopsies were stratified by technique, visibility in transrectal ultrasound and analysed by comparing PP versus DFH. A standardised anaesthesia protocol with 1% mepivacaine was used in all biopsies. The tolerability of the procedures was assessed using a visual analogue scale (VAS).ResultsThe number of mpMRI targets sampled was 166 in PP and 242 in DFH. In target biopsies, the PP system was associated with better diagnostic performance for clinically significant prostate cancer (Gleason score ≥3 + 4) compared to DFH for both ultrasound‐visible targets (61.4% vs. 48.0%) and non‐visible targets (41.4% vs. 14.9%) (p = 0.02). A higher rate of positive cores was obtained from targets sampled with PP (57.7% vs. 49.6%, p = 0.0002). The PP system was associated with the retrieval of significantly longer cores (p < 0.0001). There was no significant difference between the techniques regarding pain reported during the biopsy, with a median VAS of 2.7/10, although the PP device required a lower amount of anaesthetic in the periprostatic planes (4.3 ± 2.0 mL vs. 5.9 ± 1.9 mL, p < 0.0001).ConclusionThe PrecisionPoint Transperineal Access System enabled more precise and higher quality biopsies, resulting in improved histological characterisation of prostate cancer compared to the DFH approach. The use of a perineal cannula did not increase the pain perceived by patients and also required less local anaesthetic during the biopsy.

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Pain assessment after original transperineal prostate biopsy using a coaxial needle

Cited by 36 publications

References 14 publications

Does needle calibre affect pain and complication rates in patients undergoing transperineal prostate biopsy? A prospective, randomized trial

Does needle calibre affect pain and complication rates in patients undergoing transperineal prostate biopsy? A prospective, randomized trial

Use of transperineal fine needle aspiration of seminal vesicles to retrieve sperm in a man with obstructive azoospermia

Prospective per‐target analysis of the added value of the PrecisionPoint Transperineal Access System in cognitive prostate biopsy of MRI targets

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