Can pain during digital rectal examination help us to decide the necessity and the method of anesthesia for transrectal ultrasound guided prostate needle biopsy?

Int Braz J Urol. 2007 Jul-Aug;33(4):470-3; discussion 474-6. doi: 10.1590/s1677-55382007000400003.


Objective: Transrectal ultrasound (TRUS) guided prostate biopsy is well tolerated by patients but the lack of an effective marker to predict pain prevents us from determining pre-procedurally which patient group needs local anesthesia for biopsy and probe pain. Thus in this study, we investigated predictor factors for prostate biopsy and probe insertion pain.

Materials and methods: 71 patients who were undergoing prostate biopsy without anesthesia were included in the study retrospectively. Pain had been assessed with visual analogue scale (VAS 0-10). Digital rectal examination (DRE) pain was analyzed for biopsy and probe insertion pain.

Results: DRE pain was related to both probe pain and biopsy pain.

Conclusion: Although level of pain during DRE determines patients in need of local anesthesia, since the number of patients with moderate-severe pain is rather big, it seems efficient in determining the patients in need of additional anesthesia due to probe pain.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anesthesia, Local / methods*
  • Biopsy, Needle / adverse effects
  • Biopsy, Needle / methods*
  • Digital Rectal Examination / adverse effects*
  • Digital Rectal Examination / methods
  • Humans
  • Male
  • Middle Aged
  • Nerve Block / methods
  • Pain / etiology
  • Pain / prevention & control*
  • Pain Measurement
  • Prostate / diagnostic imaging
  • Prostate / pathology*
  • Prostatic Neoplasms / diagnostic imaging
  • Prostatic Neoplasms / pathology*
  • Retrospective Studies
  • Ultrasonography, Interventional