Pain Control and Its Relationship with Histopathological Outcome in TRUS-Guided Prostate Needle Biopsy: A Prospective Non-Randomized Trial

Abstract

What's known on the subject? and What does the study add? ÖZET objective Transrectal ultrasound-guided prostate biopsy (TRUS-Bx) is a standard diagnostic modality for detecting prostate cancer (PCa). Pain during biopsy is the most important problem that still needs a solution. The purpose of this study was to compare 3 pain control techniques and to investigate the relationship between the level of pain and histopathological findings. Materials and Methods 139 patients underwent prostate biopsy utilizing 3 analgesic techniques; 1-using lidocain gel (group 1), 2-pethidine+diazepam (group 2) and 3-periprostatic nerve block (group 3). Pain level, the tolerability and repetition of the procedure were questioned. The pathological findings were recorded. Results There was a statistically significant difference between group 1 and the others with regard to tolerability and repeating the procedure. The pain score during biopsy in group 1 was greater than in the other groups and those in group 2 was higher than in group 3. The mean pain score during probe insertion in group 2 was lower than in groups 1 and 3. The mean pain score taken during the biopsy was higher than that during probe insertion in group 2. However, the mean pain score during probe Amaç TRUS-biyopsi, prostat kanseri tanısında hala en kesin tanısal yöntemdir. Biyopsi esnasında oluşan ağrı ise başedilmesi gereken en önemli sorundur. Bu çalışmanın amacı, 3 farklı ağrı kontrol tekniği kıyaslamak ve ağrı düzeyi ile hastadaki mevcut patoloji arasındaki ilişkiyi araştırmaktır. gereç ve yöntem Yüz otuz dokuz hastaya, 3 farklı ağrı kontrol tekniği, kullanılarak prostat biyopsisi yapıldı. Gruplar sırasıyla; lidokain jel, petidin+diazepam, periprostatik sinir blokajı olarak belirlendi. Ağrı düzeyleri yanında, tolerabilite ve işlemi gerektiğinde tekrarlatma durumları sorgulandı. Patolojik sonuçlar kaydedildi. Bulgular Tolerabilite ve işlemi gerektiğinde tekrarlatma oranları arasındaki fark, grup 1'de diğer gruplara göre farklıydı. Ağrı skorları bakımından, grup 1 ve grup 2 diğer gruplardan istatistiksel olarak farklıydı. Prob yerleştirimi esnasındaki ağrı skorları, grup 2'de diğer gruplardan istatistiksel olarak anlamlı düzeyde farklıydı. Ayrıca, grup 2'de, biyopsi esnasında oluşan ağrı düzeyi skoru, prob yerleştirimi esnasındakinden daha fazlaydı. Ancak, grup 3 için prob yerleştirimi esnasında oluşan ağrı düzeyi skoru grup 1'dekinden farklı değildi. Gruplar arasında, patolojik sonuçlar açısından, Pain during prostate biopsy is the most important problem which need a solution. The purpose of this study is to compare 3 pain control techniques and its relationship with pathology. According to our research in the literature, our study is the first study that investigate the relationship between pain level during prostate biopsy and the exist pathology in the patient.

Comparison of the tolerability and efficacy of intra-rectal lidocaine gel with peri-prostatic nerve block as anaesthetic techniques for prostate biopsy

“…Carbocaine causes less vasodilatation and less absorption and has a longer duration of action and may thus be more effective than the lidocaine used in our study. Demir et al reported a higher mean pain score of 8.2 in the intra-rectal lidocaine gel arm of their study which compared three different anaesthetic techniques for prostate biopsy [23]. However, the patients were not randomized into groups in their study.…”

The Role of Histopathological Outcome on Pain of Transrectal Ultrasound Guided Prostate Biopsy: A Randomised Trial

“…Furthermore, Demir et al [19] also investigated the correlation between pain control method and pathological diagnosis. Findings in their study revealed anaesthesia type influences pain felt during prostate biopsy in relation to the histopathological diagnosis.…”