Preventing pain during office biopsy of the prostate

Abstract

Leaf protein concentrates (LPC) can be used as a valuable co‐product to cellulosic biofuel production and can also mitigate the food versus fuel controversy. Two major approaches have been considered for LPC production: a well‐characterized mechanical pressing method and a less studied method involving aqueous extraction with recovery using ultrafiltration. Experimental results with switchgrass extracts show low protein recovery after filtration, particularly if protein is recovered after cellulose hydrolysis. Economic modeling suggests that aqueous extraction costs less than mechanical pressing, but due to lower protein yields and lower quality, overall profit is higher for mechanical pressing versus aqueous extraction ($26/Mg feedstock vs. $14/Mg). If modest improvements can be made in extraction yields, filtration recovery, and protein quality, then the profitability of the aqueous extraction approach can be increased to $37/Mg feedstock. This study suggests that aqueous extraction is a viable alternative for LPC co‐production in a biorefinery if key improvements can be made in the process. Biotechnol. Bioeng. 2011; 108:530–537. © 2010 Wiley Periodicals, Inc.

A Randomized Controlled Comparison of Effects of Three Different Agents Used for Local Anesthesia in Transrectal Ultrasound-Guided Prostate Biopsy

“…However, periprostatic infiltration of the anesthetic is not a painless procedure in itself (1,2,3,4). Ashley et al (2) reported that this was the most painful part of the procedure. In this study, pain produced by injection was higher in amplitude than the biopsy pain measured at the time when the patient was under local anesthesia.…”

“…Transrectal ultrasound (TRUS)-guided prostate biopsy is a standard method in the diagnosis of prostate cancer. Although minimally invasive, it is not a painless procedure (1,2,3,4). Procedure-related pain especially occurs due to placement of the probe in the anal canal, movement of the probe and penetration of the needle to the prostate during biopsy (5).…”

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

“…There are established factors that influenced experience of severe pain during TRUS guided prostate biopsy; age, [6] prostate volume, [7] number of biopsy core samples, [8] sampling site [9] and pre biopsy anxiety which occurs in 67% of patients resulting in exaggerated pain perception [10][11][12] , have all been reported as significant predictors of pain. The intensity of pain felt during prostate biopsy maybe ascribed to activities performed prior to biopsy which include digital rectal examination, insertion of ultrasound probe in TRUS-guided prostate biopsy or insertion of needles in to the rectum during peri-prostatic block [13] .…”

Effectiveness of periprostatic block to prevent pain in transrectal prostate biopsy: a systematic review and a network meta-analysis

“…The European Association of Urology recommend topical anesthesia plus periprostatic nerve bundle block (PPNB) [10]; however, there are multiple trials considering other approaches like a single PPNB, only topical gels, combined therapies, among others, additionally, there is some evidence supporting that the most painful moment is the application of the anesthetic [10, 11].…”