title: Does needle calibre affect pain and complication rates in patients undergoing transperineal prostate biopsy? A prospective, randomized trial.
abstract: Transperineal prostate biopsy is a procedure that can be used to obtain histological samples from the prostate. To improve both the quality of the biopsy core samples and prostate cancer detection, we are currently performing a prospective, randomized trial comparing prostate biopsy samples obtained using an 18 G-needle to those obtained using a 16 G needle. The aim of this preliminary study was to evaluate pain and complication rates in both groups in order to assess whether performing a prostate biopsy with a larger calibre needle is a feasible procedure. One hundred and eighty-seven patients undergoing transperineal prostate biopsy were prospectively evaluated and divided into two groups. The first group (94 patients, Group A) received a transperineal prostate biopsy using a 16 G-needle and the second group (93 patients, Group B) underwent transperineal prostate biopsy with an 18 G-needle. Anaesthesia was obtained with a single perineal injection at the prostatic apex in all subjects. A visual analogue scale (VAS) and facial expression scale (FES) were used to assess pain during multiple steps of the procedure in each group. A detailed questionnaire was used to obtain information about drug use because it could potentially influence the pain and complications that patients experienced. Two weeks after the procedure, early and late complications were evaluated. Statistical analysis was carried out using non-parametric tests. Prostate Specific Antigen (PSA) and drug use were similar at baseline between the two groups. Pain during prostate biopsy, which was measured with both the VAS and FES instruments, did not differ significantly between the 18- and 16 G-needle groups, and no significant differences were found in early or late complication rates between the groups. Transperineal prostate biopsy with a 16 G-needle is a feasible procedure in terms of pain and complication rates. Further studies with larger patient populations are required to assess whether or not this procedure can improve prostate cancer detection rates.
authors.affiliation: Department of Urology, University of Modena and Reggio Emilia, Modena 41100, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Saredi
authors.forename: Saredi
authors.initials: S
authors.lastname: Giovanni
authors.forename: Maria Chiara
authors.initials: MC
authors.lastname: Sighinolfi
authors.forename: Francesco
authors.initials: F
authors.lastname: Fidanza
authors.forename: Fidanza
authors.initials: F
authors.lastname: Francesco
authors.forename: Stefano
authors.initials: S
authors.lastname: De Stefani
authors.forename: De Stefani
authors.initials: de S
authors.lastname: Stefano
authors.forename: Salvatore
authors.initials: S
authors.lastname: Micali
authors.forename: Micali
authors.initials: M
authors.lastname: Salvatore
authors.forename: Paterlini
authors.initials: P
authors.lastname: Maurizio
authors.forename: Maurizio
authors.initials: M
authors.lastname: Paterlini
authors.forename: Roberto
authors.initials: R
authors.lastname: D'Amico
authors.forename: Giampaolo
authors.initials: G
authors.lastname: Bianchi
authors.forename: Bianchi
authors.initials: B
authors.lastname: Giampaolo
mesh_terms: D000368:Aged; D001707:Biopsy, Needle / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D009339:Needles / Q000009:adverse effects; D010146:Pain / Q000209:etiology*; D010147:Pain Measurement / Q000379:methods; D011467:Prostate / Q000473:pathology*