title: Acceptance of repeat transrectal ultrasonography guided prostate biopsies with local anaesthesia.
abstract: OBJECTIVE
  • To measure patient discomfort associated with transrectal ultrasonography guided prostate biopsy (TRUSPB) performed with periprostatic local anaesthetic (LA) infiltration and to document agreement to possible repeat biopsy, as a recent audit showed that 86% of Australian urologists performed prostate biopsies using sedation or general anaesthesia (GA), which implies many urologists think patients are unwilling to tolerate the procedure under LA block and/or may refuse a repeat procedure.
  
  
  METHODS
  • This was a prospective cohort study following all men undergoing TRUSPB in 2008. • Immediately after the procedure the men were asked to complete a visual analogue pain score. • They were then asked whether, if it was necessary to have a repeat biopsy, they would agree to LA again or request GA/sedation.
  
  
  RESULTS
  • In all, 476 men participated in the study with a mean age of 64 years. • Of these, 464 men (97.5%) tolerated the procedure well and would, if required, agree to repeat biopsy with LA. • Only 12 men (2.5%) indicated they would request GA/sedation if a repeat biopsy was necessary.
  
  
  CONCLUSIONS
  • The vast majority of men accepted having prostate biopsy with LA infiltration and therefore this should be the first method offered. • It may be possible to screen for men who would not tolerate biopsy under LA. • Resource saving by performing most biopsies under LA can be estimated to be >A$10 million annually.
authors.affiliation: Department of Urology, Westmead Hospital, Sydney, Australia.
authors.forename: Tania
authors.initials: T
authors.lastname: Hossack
authors.forename: Henry H
authors.initials: HH
authors.lastname: Woo
mesh_terms: D000367:Age Factors; D000368:Aged; D000772:Anesthesia, Local / Q000379:methods*; D001315:Australia; D001707:Biopsy, Needle / Q000009:adverse effects / Q000379:methods*; D016009:Chi-Square Distribution; D015331:Cohort Studies; D016001:Confidence Intervals; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology / Q000517:prevention & control*; D010349:Patient Compliance / Q000706:statistics & numerical data*; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D018570:Risk Assessment; D018084:Ultrasonography, Interventional / Q000379:methods