Patient-reported pain associated with grid-based transperineal magnetic resonance imaging (MRI)/ultrasound (US) software fusion biopsy of the prostate under local anesthesia: a multicenter experience.

Prostate cancer (PC) fusion biopsy local anesthesia pain transperineal biopsy

Journal

Translational andrology and urology
ISSN: 2223-4691
Titre abrégé: Transl Androl Urol
Pays: China
ID NLM: 101581119

Informations de publication

Date de publication:
31 Aug 2023
Historique:
received: 03 03 2023
accepted: 07 07 2023
medline: 8 9 2023
pubmed: 8 9 2023
entrez: 8 9 2023
Statut: ppublish

Résumé

Biopsy by transperineal (TP) approach is recommended standard for prostate cancer (PC) diagnosis. To avoid pain, patients undergoing TP biopsy may be offered sedation or general anesthesia. Our aim was to investigate the degree of patient-reported pain for magnetic resonance imaging (MRI)/ultrasound (US) fusion biopsy of the prostate being performed under local anesthesia (LA) and to study for possible factors associated with increased risk of significant pain (SP) in this setting. In this retrospective observational study, we reviewed data of consecutive patients without a prior diagnosis of PC who underwent MRI/US software fusion biopsy of the prostate under LA with lidocaine at two centers between May 2020 and April 2022, and who reported their periprocedural pain on a Wong-Baker FACES Pain Rating Scale (0-10). We defined SP as reported pain score of 6-10. Patient and procedure characteristics together with SP were studied for interdependencies. A total of 299 patients were included. Median pain score was 2 (interquartile range: 2-4), with SP having been reported by 55 (18.4%) patients. Among patient characteristics, only age demonstrated association with SP [odds ratio (OR), per 10 years =0.53, 95% confidence interval (CI): 0.35-0.80, P=0.003] and patients aged 62 or above were significantly less likely to report SP (OR =0.33, 95% CI: 0.18-0.60, P<0.001). Performing TP MRI/US fusion prostate biopsy under LA is associated with low rates of SP, with the risk being significantly lower in older men. The results of this study can serve as evidence resource for preprocedural counselling in patients especially concerned about the risk of pain.

Sections du résumé

Background UNASSIGNED
Biopsy by transperineal (TP) approach is recommended standard for prostate cancer (PC) diagnosis. To avoid pain, patients undergoing TP biopsy may be offered sedation or general anesthesia. Our aim was to investigate the degree of patient-reported pain for magnetic resonance imaging (MRI)/ultrasound (US) fusion biopsy of the prostate being performed under local anesthesia (LA) and to study for possible factors associated with increased risk of significant pain (SP) in this setting.
Methods UNASSIGNED
In this retrospective observational study, we reviewed data of consecutive patients without a prior diagnosis of PC who underwent MRI/US software fusion biopsy of the prostate under LA with lidocaine at two centers between May 2020 and April 2022, and who reported their periprocedural pain on a Wong-Baker FACES Pain Rating Scale (0-10). We defined SP as reported pain score of 6-10. Patient and procedure characteristics together with SP were studied for interdependencies.
Results UNASSIGNED
A total of 299 patients were included. Median pain score was 2 (interquartile range: 2-4), with SP having been reported by 55 (18.4%) patients. Among patient characteristics, only age demonstrated association with SP [odds ratio (OR), per 10 years =0.53, 95% confidence interval (CI): 0.35-0.80, P=0.003] and patients aged 62 or above were significantly less likely to report SP (OR =0.33, 95% CI: 0.18-0.60, P<0.001).
Conclusions UNASSIGNED
Performing TP MRI/US fusion prostate biopsy under LA is associated with low rates of SP, with the risk being significantly lower in older men. The results of this study can serve as evidence resource for preprocedural counselling in patients especially concerned about the risk of pain.

Identifiants

pubmed: 37680225
doi: 10.21037/tau-23-139
pii: tau-12-08-1250
pmc: PMC10481192
doi:

Types de publication

Journal Article

Langues

eng

Pagination

1250-1258

Informations de copyright

2023 Translational Andrology and Urology. All rights reserved.

Déclaration de conflit d'intérêts

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://tau.amegroups.com/article/view/10.21037/tau-23-139/coif). The authors have no conflicts of interest to declare.

Références

Radiographics. 2016 Jan-Feb;36(1):162-75
pubmed: 26587887
Prostate Cancer Prostatic Dis. 2020 Sep;23(3):429-434
pubmed: 31896767
Br J Radiol. 2022 Mar 1;95(1131):20210413
pubmed: 34357796
Urology. 2020 Dec;146:25-31
pubmed: 32335086
World J Surg Oncol. 2019 Feb 13;17(1):31
pubmed: 30760274
Prostate Cancer Prostatic Dis. 2020 Sep;23(3):449-456
pubmed: 31953483
Arch Ital Urol Androl. 2014 Dec 30;86(4):284-7
pubmed: 25641452
World J Urol. 2021 Oct;39(10):3861-3866
pubmed: 33866401
ANZ J Surg. 2022 Jun;92(6):1480-1485
pubmed: 35274426
Eur J Pain. 2017 Jul;21(6):955-964
pubmed: 28230292
EClinicalMedicine. 2023 Mar 23;58:101919
pubmed: 37007736
BJU Int. 2020 Feb;125(2):244-252
pubmed: 30431694
Nat Rev Urol. 2021 Jun;18(6):315-317
pubmed: 33649503
Can Urol Assoc J. 2022 Jul;16(7):E350-E356
pubmed: 35230932
Int J Environ Res Public Health. 2020 Apr 26;17(9):
pubmed: 32357440
Eur Urol Oncol. 2021 Dec;4(6):904-913
pubmed: 33478936
J Endourol. 2021 Apr;35(4):525-543
pubmed: 33380279
Urol Oncol. 2020 Aug;38(8):650-660
pubmed: 32505458
J Urol. 2021 Mar;205(3):653-663
pubmed: 33026903
Sci Rep. 2015 Nov 03;5:16089
pubmed: 26526558
J Urol. 2019 Jun;201(6):1121-1126
pubmed: 30835607
Clin Genitourin Cancer. 2019 Oct;17(5):e860-e870
pubmed: 31281065
BJU Int. 2023 Jun;131(6):694-704
pubmed: 36695816
J Urol. 2020 Dec;204(6):1209-1215
pubmed: 32628099
Nat Rev Urol. 2013 Dec;10(12):690-702
pubmed: 24061531
Neurosci Biobehav Rev. 2017 Apr;75:104-113
pubmed: 28159611
Prostate Cancer Prostatic Dis. 2023 Sep;26(3):581-587
pubmed: 36631536
J Urol. 2021 Dec;206(6):1403-1410
pubmed: 34288719
BJUI Compass. 2021 Sep 10;2(6):428-435
pubmed: 35474705
Niger J Clin Pract. 2015 Jan-Feb;18(1):110-4
pubmed: 25511354
Prostate Cancer Prostatic Dis. 2021 Mar;24(1):169-176
pubmed: 32759972
Investig Clin Urol. 2019 Sep;60(5):388-395
pubmed: 31501802

Auteurs

Stanisław Szempliński (S)

Second Department of Urology, Centre of Postgraduate Medical Education, Warsaw, Poland.

Hubert Kamecki (H)

Second Department of Urology, Centre of Postgraduate Medical Education, Warsaw, Poland.

Mateusz Mokrzyś (M)

Department of Urology, St. Anna Hospital, Piaseczno, Poland.

Marek Zawadzki (M)

Department of Urology, St. Anna Hospital, Piaseczno, Poland.

Bartłomiej Zagożdżon (B)

Second Department of Urology, Centre of Postgraduate Medical Education, Warsaw, Poland.

Małgorzata Dębowska (M)

Nałęcz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, Warsaw, Poland.

Roman Sosnowski (R)

Department of Urology and Oncological Urology, Warmian-Masurian Cancer Center, Olsztyn, Poland.

Sławomir Poletajew (S)

Second Department of Urology, Centre of Postgraduate Medical Education, Warsaw, Poland.

Piotr Kryst (P)

Second Department of Urology, Centre of Postgraduate Medical Education, Warsaw, Poland.

Łukasz Nyk (Ł)

Second Department of Urology, Centre of Postgraduate Medical Education, Warsaw, Poland.

Classifications MeSH