title: Effect of patient position on pain scales during transrectal ultrasound-guided prostate biopsy.
abstract: OBJECTIVE
  Transrectal ultrasound (TRUS)-guided prostate biopsy is the most useful technique for the diagnosis of prostate cancer; however, many patients describe the procedure as uncomfortable and painful. We investigated the effect of the patient's position on pain scales during TRUS-guided prostate biopsy.
  
  
  METHODS
  Between July 2012 and June 2013, a total of 128 consecutive patients who underwent TRUS-guided prostate biopsy were included in this study. Seventy patients underwent the procedure in the lithotomy position performed by a urologist and the other patients (n=58) underwent the procedure in the left lateral decubitus (LLD) position performed by a radiologist. Pain was assessed by using visual analogue scale (VAS) scores from 0 to 10. Using a linear regression model, we analyzed the correlation between pain scale score and clinical variables with a focus on patient position.
  
  
  RESULTS
  No significant differences related to age, body mass index, prostate volume, prostate-specific antigen (PSA), hematuria, pyuria, International Prostate Symptom Score, or the cancer detection rate were observed between the lithotomy and the LLD groups. In the correlation analysis, VAS score showed a significant correlation with diabetes mellitus, PSA level, and lithotomy position (p<0.05). In the multiple linear regression model, VAS score showed a significant correlation with lithotomy position (β=-0.772, p=0.003) and diabetes mellitus (β=-0.803, p=0.033).
  
  
  CONCLUSIONS
  We suggest that the lithotomy position may be the proper way to reduce pain during TRUS-guided prostate biopsy.
authors.affiliation: Department of Urology, Yeungnam University College of Medicine, Daegu, Korea.
authors.forename: Yeong Uk
authors.initials: YU
authors.lastname: Kim
authors.affiliation: Department of Urology, Yeungnam University College of Medicine, Daegu, Korea.
authors.forename: Yoon Seob
authors.initials: YS
authors.lastname: Ji
authors.affiliation: Department of Urology, Yeungnam University College of Medicine, Daegu, Korea.
authors.forename: Young Hwii
authors.initials: YH
authors.lastname: Ko
authors.affiliation: Department of Urology, Yeungnam University College of Medicine, Daegu, Korea.
authors.forename: Phil Hyun
authors.initials: PH
authors.lastname: Song
mesh_terms: D000368:Aged; D001707:Biopsy, Needle / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology / Q000517:prevention & control*; D010147:Pain Measurement / Q000379:methods; D056888:Patient Positioning / Q000379:methods*; D011187:Posture / Q000502:physiology; D011471:Prostatic Neoplasms / Q000473:pathology*; D012189:Retrospective Studies; D018084:Ultrasonography, Interventional / Q000379:methods
keywords: Biopsy; Pain; Patient positioning