title: Pain related and overall morbidity with TRUS guided prostate biopsy--a prospective study.
abstract: OBJECTIVE
  To assess analgesia requirement after trans-rectal ultrasound guided prostate biopsy(TRUSBx) for appropriate counselling.
  
  
  METHODS
  Prospectively, successive patients undergoing TRUSBx between July 2009 and November 2011 were given questionnaires prior to procedure. Standard 12-core TRUSBx under peri-prostatic block (10 mL of 1% lidocaine) and antibiotic prophylaxis (oral ciprofloxacin, intravenous gentamicin and metronidazole suppository) were performed. Pain perception was assessed using a Visual Analogue Score (VAS).
  
  
  RESULTS
  Mean (range) age of the 405 patients was 67.3 years (48-88). Mean VAS during the procedure was 2.93 and 2.20 on reaching home. Mean maximum VAS for the cohort on day 1 and day 2 were 1.27 and 0.7 respectively. 140 (35%) were independent with some or minimal discomfort. 14 patients required assistance for some of their basic daily needs. 9 patients (2.2%) were hospitalised due to sepsis. 131 patients (32.4%) required additional oral analgesia following TRUSBx on days 0, 1 and 2. These patients were generally younger with a mean age for this group of 63.6 years (46-88). The difference in the mean age between those self-medicating and not was not statistically significant (p > 0.005). This group had mean VAS during the procedure of 4 and when patients reached home was 3.5. Mean maximum VAS on day 1 and 2 was 2.1 and 1.3 respectively. 11 patients required assistance from another adult.
  
  
  CONCLUSIONS
  A third of patients required self-medicated analgesia post-procedure. Age alone cannot be used as a criterion to identify patients who will subsequently require analgesia post-procedure, but a higher VAS during the procedure may be indicative. These patients must be counselled appropriately.
authors.affiliation: Department of Urology, East Lancashire Hospitals NHS Trust, Blackburn, United Kingdom.
authors.forename: Sarvpreet S
authors.initials: SS
authors.lastname: Ubee
authors.forename: Rajendra R
authors.initials: RR
authors.lastname: Marri
authors.forename: Shalom J
authors.initials: SJ
authors.lastname: Srirangam
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000698:Analgesia / Q000379:methods*; D000779:Anesthetics, Local / Q000627:therapeutic use; D006801:Humans; D061705:Image-Guided Biopsy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy; D010147:Pain Measurement; D010149:Postoperative Pain; D011446:Prospective Studies; D011467:Prostate / Q000000981:diagnostic imaging / Q000473:pathology*; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D011795:Surveys and Questionnaires; D013997:Time Factors; D018084:Ultrasonography, Interventional / Q000379:methods; D064232:Visual Analog Scale
chemical_list: D000779:Anesthetics, Local