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.