Pain Control and Its Relationship with Histopathological Outcome in TRUS-Guided Prostate Needle Biopsy: A Prospective Non-Randomized Trial

Objective\udTransrectal ultrasound-guided prostate biopsy (TRUS-Bx) is a standard\uddiagnostic modality for detecting prostate cancer (PCa). Pain during\udbiopsy is the most important problem that still needs a solution. The\udpurpose of this study was to compare 3 pain control techniques and\udto investigate the relationship between the level of pain and histopathological\udfindings.\udMaterials and Methods\ud139 patients underwent prostate biopsy utilizing 3 analgesic techniques;\ud1- using lidocain gel (group 1), 2- pethidine+diazepam (group 2) and\ud3- periprostatic nerve block (group 3). Pain level, the tolerability and\udrepetition of the procedure were questioned. The pathological findings\udwere recorded.\udResults\udThere was a statistically significant difference between group 1 and the\udothers with regard to tolerability and repeating the procedure. The pain\udscore during biopsy in group 1 was greater than in the other groups\udand those in group 2 was higher than in group 3. The mean pain score\udduring probe insertion in group 2 was lower than in groups 1 and 3. The\udmean pain score taken during the biopsy was higher than that during\udprobe insertion in group 2. However, the mean pain score during probeinsertion in group 3 was not different from that in group 1. There was no\udsignificant difference in pathological results between group 1 and groups\ud2 and 3. Pain scores in patients with chronic prostatitis were statistically\udhigher than those in patients with benign prostatic hyperplasia (BPH) and\udPca in groups 2 and 3 (p<0.05).\udConclusion\udPeriprostatic nerve block is superior to the others. However, it is not\udbetter than pethidine plus diazepam during rectal probe insertion. In the\udpresence of chronic prostatitis, pain scores can increase regardless of the\udpain control method