Assessment and clinical factors associated with pain in patients undergoing transrectal prostate biopsy.
OBJECTIVE
To quantify the degree of pain experienced by patients who undergo ultrasound-guided transrectal prostate biopsy in standard clinical practice and assess the clinical factors associated with increased pain.


METHODS
Analysis of a multicenter series of patients with prostate biopsy according to standard clinical practice. The biopsy was performed transrectally with a protocol of local anesthesia on the posterolateral nerve bundle. The pain was assessed at 20minutes into the procedure using the visual analog scale (0-10). The degree of pain was analyzed, and the association was studied using a univariate/multivariate analysis of selected clinical variables and the degree of pain.


RESULTS
A total of 1188 patients with a median age of 64 years were analyzed. Thirty percent of the biopsies were diagnosed with a tumor. The median pain score was 2, with 65% of the patients reporting a pain score ≤2. The multivariate analysis showed that the prostate volume (RR, 1.34; 95% CI 1.01-1.77; P=.04), having a previous biopsy (RR, 2.25; 95% CI 1.44-3.52; P<.01), age (RR, .63; 95% CI .47-.85; P<.01) and feel palpation (RR, 1.95; 95% CI 1.28-2.96; P<.01) were factors independently associated with greater pain during the procedure.


CONCLUSIONS
Transrectal biopsy with local anesthesia is a relatively painless technique. Factors such as age, a previous biopsy, pain on being touched and prostate volume were associated with the presence of greater pain during the procedure.
Servicio de Urología, IMIBIC, Hospital Universitario Reina Sofía, Universidad de Córdoba, Córdoba, España. Electronic address: enriquegomezgomez@yahoo.es.
E
E
Gómez-Gómez
Servicio de Urología, Instituto Valenciano de Oncología, Valencia, España.
M
M
Ramírez
Servicio de Urología, Instituto Valenciano de Oncología, Valencia, España.
A
A
Gómez-Ferrer
Servicio de Urología, Instituto Valenciano de Oncología, Valencia, España.
J
J
Rubio-Briones
Servicio de Urología, Instituto Valenciano de Oncología, Valencia, España.
I
I
Iborra
Servicio de Urología, IMIBIC, Hospital Universitario Reina Sofía, Universidad de Córdoba, Córdoba, España.
J Carrasco-Valiente
Servicio de Urología, IMIBIC, Hospital Universitario Reina Sofía, Universidad de Córdoba, Córdoba, España.
J P
JP
Campos
Servicio de Urología, IMIBIC, Hospital Universitario Reina Sofía, Universidad de Córdoba, Córdoba, España.
J
J
Ruiz-García
Servicio de Urología, IMIBIC, Hospital Universitario Reina Sofía, Universidad de Córdoba, Córdoba, España.
M J
MJ
Requena-Tapia
Servicio de Urología, Instituto Valenciano de Oncología, Valencia, España.
E
E
Solsona
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000772:Anesthesia, Local; D006801:Humans; D061705:Image-Guided Biopsy / Q000009:adverse effects / Q000379:methods; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology*; D010147:Pain Measurement; D011467:Prostate / Q000000981:diagnostic imaging / Q000473:pathology*; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D012007:Rectum; D012189:Retrospective Studies; D018084:Ultrasonography, Interventional; D013520:Urologic Surgical Procedures / Q000009:adverse effects
Biopsia prostática transrectal; Cáncer de próstata; Diagnóstico; Escala analógica del dolor; Prostate cancer, Diagnosis, Analog pain scale, Transrectal prostate biopsy