Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Jul-Aug;46(4):557-562.
doi: 10.1590/S1677-5538.IBJU.2019.0154.

Comparison of pain levels in fusion prostate biopsy and standard TRUS-Guided biopsy

Affiliations

Comparison of pain levels in fusion prostate biopsy and standard TRUS-Guided biopsy

Abdullah Demirtaş et al. Int Braz J Urol. 2020 Jul-Aug.

Abstract

Objectives: Fusion prostate biopsy (FPB) has recently emerged as a popular and successful biopsy technique on diagnosis of prostate cancer. The aim of this study was to compare the pain levels in TRUS-guided standard 12-core prostate biopsy (SPB) and MpMRI-guided FPB.

Materials and methods: Patients detected with a PI-RADS (Prostate Imaging Reporting and Data System) ≥3 lesion on MpMRI underwent MpMRI-guided FPB (Group I) and the patients who had no suspected lesions or had a PI-RADS<3 lesion on MpMRI underwent TRUS-guided SPB (Group II). Pain assessment was performed using Visual Analog Scale (VAS) five minutes after the procedure. Following the procedure, the patients were asked to indicate the most painful biopsy step among the three steps.

Results: 252 patients were included in this study (Group I=159, Group II=93). The mean number of cores and the malignancy detection rate were significantly higher in Group I compared to Group II (p<0.001, p=0.043, respectively). No significant difference was found between the two groups with regard to VAS scores (p=0.070). The most painful part of the whole procedure was revealed to be the insertion of the probe into the rectum. However, no significant difference was found between the two groups with regard to the most painful biopsy step (p=0.140).

Conclusion: FPB, with a relatively higher cancer detection rate, leads to the same pain level as SPB although it increases the number of biopsy cores and involves a more complex procedure compared to SPB. Further prospective studies with larger patient series are needed to substantiate our findings.

Keywords: Biopsy; Pain; Prostate.

PubMed Disclaimer

Conflict of interest statement

None declared.

Figures

Figure 1
Figure 1. Visual Analog Scale.

Comment in

References

    1. 1. Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015;136:E359-86. - PubMed
    2. Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015;136:E359–E386. - PubMed
    1. 2. Autorino R, De Sio M, Di Lorenzo G, Damiano R, Perdonà S, Cindolo L, et al. How to decrease pain during transrectal ultrasound guided prostate biopsy: a look at the literature. J Urol. 2005;174:2091-7. - PubMed
    2. Autorino R, De Sio M, Di Lorenzo G, Damiano R, Perdonà S, Cindolo L, et al. How to decrease pain during transrectal ultrasound guided prostate biopsy: a look at the literature. J Urol. 2005;174:2091–2097. - PubMed
    1. 3. Mazdak H, Abtahi AM, Momeni F, Izadpanahi MH. A comparison of pain control and complications using three different ways of anesthesia in patients undergoing transrectal ultrasound-guided prostate biopsy. J Res Med Sci. 2018;23:17. - PMC - PubMed
    2. Mazdak H, Abtahi AM, Momeni F, Izadpanahi MH. A comparison of pain control and complications using three different ways of anesthesia in patients undergoing transrectal ultrasound-guided prostate biopsy. 17J Res Med Sci. 2018;23 - PMC - PubMed
    1. 4. Wang N, Fu Y, Ma H, Wang J, Gao Y. Advantages of caudal block over intrarectal local anesthesia plus periprostatic nerve block for transrectal ultrasound guided prostate biopsy. Pak J Med Sci. 2016;32:978-82. - PMC - PubMed
    2. Wang N, Fu Y, Ma H, Wang J, Gao Y. Advantages of caudal block over intrarectal local anesthesia plus periprostatic nerve block for transrectal ultrasound guided prostate biopsy. Pak J Med Sci. 2016;32:978–982. - PMC - PubMed
    1. 5. Yang Y, Liu Z, Wei Q, Cao D, Yang L, Zhu Y, et al. The Efficiency and Safety of Intrarectal Topical Anesthesia for Transrectal Ultrasound-Guided Prostate Biopsy: A Systematic Review and Meta-Analysis. Urol Int. 2017;99:373-83. - PubMed
    2. Yang Y, Liu Z, Wei Q, Cao D, Yang L, Zhu Y, et al. The Efficiency and Safety of Intrarectal Topical Anesthesia for Transrectal Ultrasound-Guided Prostate Biopsy: A Systematic Review and Meta-Analysis. Urol Int. 2017;99:373–383. - PubMed