Perineal nerve block versus periprostatic block for patients undergoing transperineal prostate biopsy (APROPOS): a...

Area of Science:

• Urology
• Anesthesiology
• Oncology

Background:

• Transperineal prostate biopsy is a common procedure for diagnosing prostate cancer.
• Effective pain management is crucial for patient comfort and procedural success.
• Current anesthetic techniques include periprostatic block and perineal nerve block.

Purpose of the Study:

• To compare the efficacy of perineal nerve block versus periprostatic block for pain control during transperineal prostate biopsy.
• To evaluate secondary outcomes including post-biopsy pain, vital sign changes, and cancer detection rates.

Main Methods:

• A prospective, randomized, blinded, parallel-group trial involving 192 men across six Chinese hospitals.
• Participants were randomly assigned to receive either a perineal nerve block or a periprostatic block before biopsy.
• Pain levels, vital signs, pain manifestations, anesthesia satisfaction, and cancer detection rates were assessed.

Main Results:

• Perineal nerve block demonstrated significantly superior pain relief during the procedure (mean pain score 2.80 vs 3.98).
• It also showed better control of vital sign fluctuations and reduced external pain manifestations.
• Anesthesia satisfaction was higher with perineal nerve block, with comparable prostate cancer detection rates.

Conclusions:

• Perineal nerve block is a more effective anesthetic technique for managing pain during transperineal prostate biopsies.
• It offers improved patient comfort and satisfaction without compromising cancer diagnostic yield.