Development and External Validation of a Nomogram for Predicting Pain Risk Post-Transperineal Prostate Biopsy Using...

Area of Science:

• Urology
• Pain Management
• Medical Informatics

Background:

• Ultrasound-guided transperineal prostate biopsy (TPB) is a common procedure.
• Managing moderate-to-severe pain (NRS > 4) post-TPB is crucial for patient comfort and adherence.
• Predictive models for pain are needed to guide perioperative management.

Purpose of the Study:

• To identify factors associated with moderate-to-severe pain following TPB.
• To develop and validate a nomogram model for assessing TPB-related pain risk.
• To establish a tool for personalized pain management strategies.

Main Methods:

• A cohort of 520 patients undergoing TPB was divided into training (n=400) and validation (n=120) groups.
• Binary logistic regression identified risk factors for moderate-to-severe pain.
• A nomogram risk assessment model was constructed and validated internally and externally.

Main Results:

• Prostate volume, anxiety score, diabetes history, biopsy time, and needle count were significant risk factors.
• Age was identified as a protective factor against pain.
• The nomogram demonstrated high predictive accuracy (AUC 0.940 training, 0.893 internal validation, 0.888 external validation).

Conclusions:

• The developed nomogram is a robust tool for stratifying patients at risk of moderate-to-severe pain after TPB.
• The model's strong performance across internal and external validation supports its clinical applicability.
• This risk stratification tool facilitates personalized perioperative pain management for TPB patients.