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Asian Journal of Andrology (2009) 11 : 678-682. doi: 10.1038/aja.2009.43; published online 21 September 2009.
Does needle calibre affect pain and complication rates in patients undergoing transperineal prostate biopsy? A prospective, randomized trial
Saredi Giovanni1, Maria Chiara Sighinolfi1, Fidanza Francesco1, De Stefani Stefano1, Micali Salvatore1, Maurizio Paterlini1, Roberto D'Amico2 and Bianchi Giampaolo1
1 Department of Urology, University of Modena and Reggio Emilia, Modena 41100, Italy
2 Department of Oncology, University of Modena and Reggio Emilia, Modena 41100, Italy
Correspondence: Dr Maria Chiara Sighinolfi, Department of Urology, University of Modena and Reggio Emilia, Via del Pozzo 71, Modena 41100, Italy. Fax: +39-059-422-2863 E-mail: sighinolfic@yahoo.com
Received 15 April 2009; Revised 16 June 2009; Accepted 25 June 2009; Published online 21 September 2009.
| Abstract |
Transperineal prostate biopsy is a procedure that can be used to obtain histological samples from the prostate. To improve both the quality of the biopsy core samples and prostate cancer detection, we are currently performing a prospective, randomized trial comparing prostate biopsy samples obtained using an 18 G-needle to those obtained using a 16 G needle. The aim of this preliminary study was to evaluate pain and complication rates in both groups in order to assess whether performing a prostate biopsy with a larger calibre needle is a feasible procedure. One hundred and eighty-seven patients undergoing transperineal prostate biopsy were prospectively evaluated and divided into two groups. The first group (94 patients, Group A) received a transperineal prostate biopsy using a 16 G-needle and the second group (93 patients, Group B) underwent transperineal prostate biopsy with an 18 G-needle. Anaesthesia was obtained with a single perineal injection at the prostatic apex in all subjects. A visual analogue scale (VAS) and facial expression scale (FES) were used to assess pain during multiple steps of the procedure in each group. A detailed questionnaire was used to obtain information about drug use because it could potentially influence the pain and complications that patients experienced. Two weeks after the procedure, early and late complications were evaluated. Statistical analysis was carried out using non-parametric tests. Prostate Specific Antigen (PSA) and drug use were similar at baseline between the two groups. Pain during prostate biopsy, which was measured with both the VAS and FES instruments, did not differ significantly between the 18- and 16 G-needle groups, and no significant differences were found in early or late complication rates between the groups. Transperineal prostate biopsy with a 16 G-needle is a feasible procedure in terms of pain and complication rates. Further studies with larger patient populations are required to assess whether or not this procedure can improve prostate cancer detection rates.
Keywords: needle calibre, prostatic biopsy, side effects |
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