Comparison of Pain Levels in Fusion Prostate Biopsy and Standard TRUS-Guided Biopsy

Comparison of Pain Levels in Fusion Prostate Biopsy and Standard TRUS-Guided Biopsy

The aim of this study was to compare the pain levels in transrectal ultrasound (TRUS)-guided standard 12-core prostate biopsy (SPB) and multiparametric prostate magnetic resonance imaging (MpMRI)-guided fusion prostate biopsy (FPB).

The study included patients that underwent prostate biopsy under local anesthesia (intrarectal 2% lidocaine gel + periprostatic nerve block) due to suspected prostate cancer. Patients detected with a Prostate Imaging Reporting and Data System score (PIRADS) ≥3 lesion on MpMRI underwent MpMRI-guided FPB (Group I) and the patients who had no suspected lesions or had a PI-RADS <3 lesion on MpMRI underwent TRUS-guided SPB (Group II). Pain assessment was performed using Visual Analog Scale (VAS) 5 min after the procedure. Following the procedure, the patients were asked to indicate the most painful biopsy step among the three steps (1: insertion of the probe into the rectum, 2: probe manipulation, 3: the piercing of the biopsy needle).

Inclusion Criteria:

• Elevated blood prostate specific antigen (PSA) levels according to patients age. PSA >2ng/ml for whom aged between 50-60, and PSA >4ng/ml for whom were above 60 years old
• Having suspicious digital rectal examination
• having multi-parametric prostate MRI before prostate biopsy
• Having MRI defined lesions which were PIRADS - 3 -4-5

Exclusion Criteria:

• PSA > 50 ng/ml
• previous negative biopsy
• neurological disorders that could affect the pain level such as paraplegia or hemiplegia, analgesics use for any reason on the day of or the day before the procedure,
• patients underwent biopsy under general anesthesia,
• having such diseases as anal fissure or hemorrhoidal disease that could alter the pain threshold