How to decrease pain during transrectal ultrasound guided prostate biopsy: a look at the literature.
OBJECTIVE
There is growing interest among urologists on the need for decreasing pain during transrectal ultrasound (TRUS) guided prostate biopsy.


METHODS
We performed a systematic MEDLINE search of clinical trials of any kind of anesthesia, analgesia or sedation during TRUS guided prostate biopsy published since 2000. We critically analyzed the impact of pain and discomfort associated with the procedure, the described methods for evaluating it and the different techniques that have been described.


RESULTS
There is strong evidence in the current literature that patient tolerance and comfort during TRUS guided prostate biopsy can be improved by anesthesia/analgesia. What remains is the need to urge all urologists to introduce it in clinical practice as a routine part of the procedure, whatever the biopsy scheme.


CONCLUSIONS
Of the various options periprostatic anesthetic infiltration has been shown to be safe, easy to perform and highly effective. It should be considered the gold standard at the moment, even if the optimal technique remains to be established. Further studies addressing this issue are warranted.
Autorino
Riccardo
R
Urology Clinic, Second University, Department of Oncology, Federico II University, Vico Santo Spirito 54, 80132 Naples, Italy. ricautor@tin.it
De Sio
Marco
M
Di Lorenzo
Giuseppe
G
Damiano
Rocco
R
Perdonà
Sisto
S
Cindolo
Luca
L
D'Armiento
Massimo
M
D000777:Anesthetics / Q000008:administration & dosage*; D001340:Autonomic Nerve Block; D001706:Biopsy / Q000009:adverse effects* / Q000379:methods; D002986:Clinical Trials as Topic; D005782:Gels; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D008297:Male; D010146:Pain / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control*; D010147:Pain Measurement; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology*; D018084:Ultrasonography, Interventional
D000777:Anesthetics; D005782:Gels