Pain assessment after original transperineal prostate biopsy using a coaxial needle.
OBJECTIVE
To assess whether the use of a coaxial needle reduces discomfort in patients undergoing multiple-core transperineal prostate biopsy to detect prostate cancer.


METHODS
From October 2002 to January 2003, we enrolled 102 consecutive patients with a suspicion of prostate cancer. In every case, we performed a 14-core transperineal prostate biopsy under transrectal ultrasound guidance. The patients were randomized into two groups: group 1 (n = 51) in which we used the 17-gauge coaxial TruGuide needle, and group 2 (n = 51) in which the conventional transperineal technique was used. At the end of the procedure, patients were asked to complete a questionnaire regarding the level of pain experienced.


RESULTS
The studied groups were comparable in age, total prostate-specific antigen value, and prostate volume. The whole procedure was significantly less painful in group 1 (2.20 +/- 1.20 versus 2.90 +/- 1.73, P = 0.01). We failed to show any significant pain score differences during rectal probe insertion (P = 0.10), transrectal ultrasonography (P = 0.16), and execution of local anesthesia (P = 0.11). The pain score recorded during the multiple-core prostate sampling was significantly lower in group 1 (1.53 +/- 1.5 versus 2.43 +/- 1.86, P = 0.009). No statistically significant differences were found in the complication rates between the two groups.


CONCLUSIONS
The use of a coaxial needle reduces the procedure's invasiveness and patient's pain compared with the conventional transperineal prostate biopsy.
Novella
Giovanni
G
Department of Urology, University of Verona, Verona, Italy.
Ficarra
Vincenzo
V
Galfano
Antonio
A
Ballario
Riccardo
R
Novara
Giacomo
G
Cavalleri
Stefano
S
Artibani
Walter
W
D000368:Aged; D001707:Biopsy, Needle / Q000009:adverse effects* / Q000295:instrumentation; D006801:Humans; D008297:Male; D008875:Middle Aged; D009339:Needles; D010146:Pain / Q000209:etiology*; D010147:Pain Measurement; D011446:Prospective Studies; D011467:Prostate / Q000000981:diagnostic imaging / Q000473:pathology*; D011795:Surveys and Questionnaires; D014463:Ultrasonography