Grand Journal of Urology
E-ISSN : 2757-7163

Can the Degree of Pain During Transrectal Ultrasound- Guided Prostate Biopsy be Predicted Before Biopsy?
Emrullah Söğütdelen1, Ramazan Kurul2, Adnan Gücük1, Eray Kemahlı1, Hüseyin Alperen Yıldız1, Uğur Üyetürk1
1Department of Urology, Bolu Abant İzzet Baysal University, Bolu, Türkiye
2Department of Physical Therapy and Rehabilitation, Bolu Abant İzzet Baysal University, Bolu, Türkiye
DOI : 10.5505/GJU.2024.18894
Pages : 070-076
Objective: To evaluate whether the assessment of anxiety and pain perception before a biopsy procedure may predict patients" perceived pain scale scores during transrectal ultrasound-guided prostate biopsy.

Materials and Methods: Patients who were administered the Mini-Mental State Examination 24 h before the biopsy were evaluated based on electrically and mechanically induced pain thresholds. Patients were assessed with Generalized Anxiety Disorder (GAD)-7 scale sscores in the hour before biopsy. The pain experienced by patients during rectal probing and biopsy was assessed using Visual Analog Scale (VAS) scores.

Results: The mean age and median PSA level of the patients were 65.52 ± 7.85 years and 9.73 (1.4-155) ng/dL, respectively. The median VAS scores during rectal probing and biopsy were 3 (0-10) and 4 (0-10) respectively. VAS scores calculated during procedures were moderately-to-strongly correlated with the index finger of mechanically induced pain pressure threshold (PPT) (r=−0.606, p=0.001 and r=−0.760, p=0.001). Multiple regression analyses revealed that severity of the intraprocedural pain was correlated with age, GAD-7, and PPT index finger scores (p=0.005, p=0.001, p=0.001, respectively). A correlation was noted between the refusal of repeat prostate biopsy and higher pain scores (p<0.001).

Conclusion: A moderate-to-strong correlation was found between pain scores evaluated after rectal probing and during prostate biopsy with PPT index finger pain and GAD-7 scores. Therefore, psychological support and/or additional anesthetic options should be considered in younger patients with high GAD-7 and PPT index finger scores before application of prostate biopsy to decrease the refusal rates of repeat biopsy.

Keywords : prostate cancer, transrectal prostate biopsy, pain, anxiety
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