Acceptance of repeat transrectal ultrasonography guided prostate biopsies with local anaesthesia

OBJECTIVE center dot To measure patient discomfort associated with transrectal ultrasonography guided prostate biopsy (TRUSPB) performed with periprostatic local anaesthetic (LA) infiltration and to document agreement to possible repeat biopsy, as a recent audit showed that 86% of Australian urologists performed prostate biopsies using sedation or general anaesthesia (GA), which implies many urologists think patients are unwilling to tolerate the procedure under LA block and/or may refuse a repeat procedure. PATIENTS AND METHODS center dot This was a prospective cohort study following all men undergoing TRUSPB in 2008. center dot Immediately after the procedure the men were asked to complete a visual analogue pain score. center dot They were then asked whether, if it was necessary to have a repeat biopsy, they would agree to LA again or request GA/sedation. RESULTS center dot In all, 476 men participated in the study with a mean age of 64 years. center dot Of these, 464 men (97.5%) tolerated the procedure well and would, if required, agree to repeat biopsy with LA. center dot Only 12 men (2.5%) indicated they would request GA/sedation if a repeat biopsy was necessary. CONCLUSION center dot The vast majority of men accepted having prostate biopsy with LA infiltration and therefore this should be the first method offered. center dot It may be possible to screen for men who would not tolerate biopsy under LA. center dot Resource saving by performing most biopsies under LA can be estimated to be > A$10 million annually.