Patient Reported Outcomes of Transperineal Prostate Biopsy With Tumescent Local Anesthesia

• Published in: Urology (Ridgewood, N.J.) N.J.), 2023-12, Vol.182, p.33-39
• Main Authors: Myrga, John M., Erpenbeck, Sarah P., Watts, Alexander, Stencel, Michael G., Staniorski, Christopher J., Patnaik, Shyam, Yabes, Jonathan G., Yu, Michelle, Allaway, Matthew J., Gorin, Michael A., Jacobs, Bruce L., Davies, Benjamin J.
• Format: Article
• Language: English
• Subjects: Anesthesia, Local - methods; Biopsy - adverse effects; Biopsy - methods; Humans; Image-Guided Biopsy - adverse effects; Image-Guided Biopsy - methods; Male; Pain - etiology; Pain - prevention & control; Patient Reported Outcome Measures; Prostate - pathology; Prostatic Neoplasms - pathology
• ISSN: 0090-4295; 1527-9995
• DOI: 10.1016/j.urology.2023.09.010

To report the outcomes of performing transperineal prostate biopsy in the office setting using the novel anesthetic technique of tumescent local anesthesia. We report anxiety, pain, and embarrassment of patients who underwent this procedure compared to patients who underwent a transrectal prostate biopsy using standard local anesthesia. Consecutive patients undergoing either a transperineal prostate biopsy under tumescent local anesthesia or a transrectal prostate biopsy with standard local anesthetic technique were prospectively enrolled. The tumescent technique employed dilute lidocaine solution administered using a self-filling syringe. Patients were asked to rate their pain before, during, and after their procedure using a visual analog scale. Patient anxiety and embarrassment was assessed using the Testing Modalities Index Questionnaire. Between April 2021 and June 2022, 430 patients underwent a transperineal prostate biopsy using tumescent local anesthesia and 65 patients underwent a standard transrectal prostate biopsy. Patients who underwent a transperineal biopsy had acceptable but significantly higher pain scores than those who underwent a transrectal prostate biopsy (3.9 vs 1.6, P-value