Ces Urol 2022, 26(3):186-192 | DOI: 10.48095/cccu2022018

Evaluation of pain of transperineal prostate biopsy under local anaesthesia

Jiří Stejskal, Vanda Adamcová, Roman Zachoval

Urologická klinika 3. lékařské fakulty a Fakultní Thomayerovy nemocnice v Praze

Stejskal J, Adamcová V, Zachoval R. Evaluation of pain of transperineal prostate biopsy under local anaesthesia.

Aim: The goal of the analysis is to evaluate patient reported pain during transperineal prostate biopsy (TPBxP) under local anaesthesia (LA).

Methods: We evaluated 55 patients who had a TPBxP under LA comprising 26 first and 29 repeated biopsies. On average 15 cores were obtained in each patient (12-18). The local anaesthesia was administered using 50cc of mesocaine applied to the perineal skin and prostate apex. No intravenous or oral analgesics were used. The patients reported the painfulness of both local anaesthesia and prostate biopsy using a scale of 1 (no pain) to 10 (highest pain imaginable). The data were then correlated with the patients' age, prostate size, PSA level and the number of taken biopsy cores.

Results: The mean patient age was 66.85 years (54-78), the mean PSA was 10.11ng/ml (0.66 - 53.6), and the average prostate size was 46cc (17-126). The mean patient reported pain was 2,04 (1-7, median 2) for the application of the LA and 4.05 (1-7, median 4) for the biopsy. There was a positive correlation between the application of LA and the biopsy itself. Furthermore, there was a negative correlation between patient age and the reported painfulness of TPBxP.

Conclusion: TPBxP is reasonably well tolerated by patients. The biopsy itself is more painful than the application of LA. Older patients tend to tolerate the procedure better. The PSA level, prostate size and the number of biopsy cores have no effect on the patient reported pain.

Keywords: Transperineal prostate biopsy, local anaesthesia, pain, prostate cancer.

Received: May 11, 2022; Revised: June 16, 2022; Accepted: June 30, 2022; Prepublished online: June 29, 2022; Published: September 21, 2022