The Severity of Pain in Prostate Biopsy Depends on the Biopsy Sector

Rempega, Grzegorz; Rajwa, Paweł; Kępiński, Michał; Ryszawy, Jakub; Wojnarowicz, Jakub; Kowalik, Maksymilian; Krzempek, Marcela; Krzywon, Aleksandra; Dobrakowski, Michał; Paradysz, Andrzej; Bryniarski, Piotr

doi:10.3390/jpm13030431

Cited by 5 publications

(4 citation statements)

References 33 publications

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“…They adduced inability to manipulate probe effectively to biopsy region of the prostate where cancer is likely to occur such as apical and far lateral region as reasons why more pain is felt [16] , as a corollary, this could be ascribed to the competence of the personel who carried out this biopsy. In another study, Rempega et al [18] established that the apex of the prostate is extremely pain sensitive part of the prostate due to predominance of somatic nerves in the area below the dentate lines, this area coincides with region where cancers are most likely to occur [16] hence maybe responsible for the deduction that there is a correlation between histopathological outcome and pain of prostate biopsy.…”

Section: Discussionmentioning

confidence: 99%

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

Ozah

Ezenwa

2023

ijirms

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Introduction: Transrectal ultrasound guided prostate biopsy is the gold standard for diagnosis of carcinoma of the prostate. The pain of prostate biopsy is of immense challenge. Many factors have been ascribed to it. Identifying such risk factors will assist in mitigating the pain associated with this procedure. This study therefore aims to assess the role of histopathological outcome on pain of TRUS guided prostate biopsy. Methods: The study was a prospective randomized study carried out in University of Benin Teaching Hospital over a 1year period between 2017 and 2018. Consecutive patients who met indications for biopsy were randomized into Group A: intrarectal xylocaine gel group and Group B: periprostatic block group. Pain was assessed during probe insertion, biopsy and one hour post biopsy using an 11-point visual analogue scale. Association between mean pain scores and histological diagnosis in both groups was assessed using the independent t- test, association between use of intrarectal xylocain gel, periprostatic block was done using the independent t-test. Level of significance set at p <0.05. Results: There was no statistically significant difference in mean pain score during probe insertion, biopsy and post biopsy (p=0.3888), (p=0.089) and (p=0.584) respectively between benign and malignant histological diagnosis for Group A, while there was also no statistically significant difference in mean pain score during probe insertion, biopsy and post biopsy (p=0.266), (p=0.506) and (p=0.522) respectively between benign and malignant histological diagnosis in Group B. Cancer detection rate for Group A and Group B was 64.3% and 59.1% respectively, which was not statistically significant p=0.662. Conclusions: The study demonstrated that pain of TRUS guided prostate biopsy is not influenced by histopathological outcome irrespective of mode of anaesthesia. Cancer detection rate was also not influenced by choice of anaesthesia during TRUS guided prostate biopsy.

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Section: Discussionmentioning

confidence: 99%

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

Ozah

Ezenwa

2023

ijirms

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“…Other symptoms it may cause are lower urinary tract symptoms (LUTS), such as nocturia and weak urine flow, erectile dysfunction and visible hematuria (3). The symptoms of prostate cancer are not specific to it and might be difficult to discriminate from benign prostate hyperplasia and inflammatory prostate diseases (4). Age, race, positive family history, dietary factors and obesity are some risk factors increasing prostate cancer risk (5).…”

Section: Introductionmentioning

confidence: 99%

“…It has been shown in the literature that the pain felt during TRUS-guided biopsy is related to the preferred anesthesia method, prostate volume, biopsy sector and PSA level (4,10,13). There are also studies in the literature investigating patient satisfaction with the prostate biopsy procedure (17,18).…”

Section: Introductionmentioning

confidence: 99%

What may be Related to Patient Satisfaction in Prostate Biopsies?

Türkmen,

Hacıosmanoğlu

2024

Endourol Bull

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Objective: To investigate the factors affecting patient satisfaction in patients undergoing prostate biopsy. Material and Methods: Two hundred thirty seven of 241 patients, aged between 48 and 86, those who are decided to undergo transrectal ultrasonography (TRUS)-guided prostate biopsy, were evaluated prospectively. Age, body mass index (BMI), prostate-specific antigen (PSA) values, prostate volume, positive digital rectal examination (DRE) findings and biopsy indications of the patients were recorded before the procedure. The level of pain felt during biopsy was scored by visualised pain scoring (VAS). Patient satisfaction was evaluated with a 4-point scale after biopsy. Results: Of the 237 patients evaluated, 92 were dissatisfied with the procedure, while 145 were satisfied. The mean age of Group 1 and Group 2 were 65.9±8.1 and 66.1 ± 7.6 years, BMI were 27.7±4.0 and 26.3 ± 3.9 kg/m2, PSA level were 58.6 ± 304.6 and 17.9 ± 68.1 ng/ml, Prostate volüme were 59.4 ± 51.8 and 51.8 ± 28.7 cc., The median VAS score 4 (3-6) and 4 (2.5-6) respectively. The Satisfaction levels of positive DRE findings Group was 3 (2-3) while negative 3 (2-3), Tumor existance Group was 3 (2-3) while no tumor Group’s Satisfaction levels 3 (2-3), Perineural invasion of tumor existance Group was 3 (2-3) while other Group’s Satisfaction levels 3 (2-3). Conclusion: In TRUS-guided prostate biopsies, no relationship was found between the patient’s satisfaction level and the patient’s age, PSA level, prostate volume, the level of pain felt, positive DRE finding, positive Tumor pathology or having perineural invasion of the tumor histologically. There is a statistically significant relationship between BMI and the level of satisfaction.

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“…It is characterized by greater sensitivity and specificity compared to systematic biopsy. It allows for the precise collection of the incised tissue due to simultaneous mpMRI and ultrasound imaging [ 5 , 6 , 7 ]. Fusion biopsy facilitates the histological assessment of the tumour tissue (based on the Gleason score), which enables further prognosis and response to treatment [ 5 , 8 , 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

The influence of the operator's experience on the outcomes of fusion prostate biopsy

2023

cent European J Urol

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Introduction Magnetic resonance imgaing (MRI) targeted biopsy is the gold standard for prostate cancer (PCa) diagnosis. In this study, we examined the association between the operator’s experience and the improvement in the precision of the MRI prostate biopsy procedure and the detection of PCa. Material and methods We included consecutive patients who underwent prostate fusion biopsy. Data on biopsy duration, prostate-specific antigen (PSA) value, lesion size, number of samples taken, number of cores involved, and International Society of Urological Pathology (ISUP) grade were subjected to statistical analysis, with the study group divided into three consecutive time periods (tertiles). Results There were statistically significant differences in biopsy duration between tertiles (p <0.001). The greatest difference in the involved/taken cores ratio occurred between the first and third tertile (p = 0.002). The difference between the first and second tertile was insignificant (p = 0.4), while the difference between the second and third tertile was statistically significant (p = 0.004). The differences between tertiles in Prostate Imaging and Reporting Data System v2.1 were also significant (p = 0.003). The PSA value (p = 0.036) was statistically significant, unlike prostate volume (p = 0.16), digital rectal examination (DRE) (p = 0.7), and ISUP grade (p = 0.7). There was no statistical difference between tested tertiles in the number of detected PCa ISUP ≥2 (Z = 0.191; p = 0.8). Conclusions The abilities and precision of the operator increase with the increase in the number of procedures performed. The biopsy duration is shortened, and the detection of PCa during the procedure seems to improve with the operator’s experience.

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The Severity of Pain in Prostate Biopsy Depends on the Biopsy Sector

Cited by 5 publications

References 33 publications

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

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

What may be Related to Patient Satisfaction in Prostate Biopsies?

The influence of the operator's experience on the outcomes of fusion prostate biopsy

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