Pain assessment after original transperineal prostate biopsy using a coaxial needle

To assess whether the use of a coaxial needle reduces discomfort in patients undergoing multiple-core transperineal prostate biopsy to detect prostate cancer.

From October 2002 to January 2003, we enrolled 102 consecutive patients with a suspicion of prostate cancer. In every case, we performed a 14-core transperineal prostate biopsy under transrectal ultrasound guidance. The patients were randomized into two groups: group 1 (n = 51) in which we used the 17-gauge coaxial TruGuide needle, and group 2 (n = 51) in which the conventional transperineal technique was used. At the end of the procedure, patients were asked to complete a questionnaire regarding the level of pain experienced.

The studied groups were comparable in age, total prostate-specific antigen value, and prostate volume. The whole procedure was significantly less painful in group 1 (2.20 +/- 1.20 versus 2.90 +/- 1.73, P = 0.01). We failed to show any significant pain score differences during rectal probe insertion (P = 0.10), transrectal ultrasonography (P = 0.16), and execution of local anesthesia (P = 0.11). The pain score recorded during the multiple-core prostate sampling was significantly lower in group 1 (1.53 +/- 1.5 versus 2.43 +/- 1.86, P = 0.009). No statistically significant differences were found in the complication rates between the two groups.

The use of a coaxial needle reduces the procedure's invasiveness and patient's pain compared with the conventional transperineal prostate biopsy.