Giancarlo Marra1, Junlong Zhuang2, Alessandro Marquis1, Xiaozhi Zhao2, Giorgio Calleris1, Yansheng Kan2, Marco Oderda1, Haifeng Huang2, Riccardo Faletti3, Qing Zhang2, Luca Molinaro4, Wei Wang2, Laura Bergamasco3, Hongqian Guo2, Paolo Gontero1. 1. Department of Urology, San Giovanni Battista Hospital, AOU Città della Salute e della Scienza and University of Turin, Turin, Italy. 2. Department of Urology, Nanjing Drum Tower Hospital, Medical School of Nanjing University, Institute of Urology, Nanjing University, Nanjing, Jiangsu, People's Republic of China. 3. Department of Radiology, San Giovanni Battista Hospital, AOU Città della Salute e della Scienza and University of Turin, Turin, Italy. 4. Department of Pathology, San Giovanni Battista Hospital, AOU Città della Salute e della Scienza and University of Turin, Turin, Italy.
Abstract
BACKGROUND: Several TP biopsy series proved feasibility under LA. However, there is a lack of large analysis detailing pain outcomes and factors influencing pain. MATERIALS AND METHODS: From 2016 to 2019 we performed a multicenter prospective study in men undergoing mpMRI-TPFBx (target+systematic cores) under LA. Primary outcomes were: i) pain scores (assessed through a 0-10 point NRS); ii) identification of factors associated with severe pain. Secondary outcome was to evaluate pain influence on csPCa target cores detection. RESULTS: We included 1,008 men undergoing TPFBx under LA. Mean NRS pain scores were 3.9±2.1 at LA administration, 3.1±2.3 when performing Bx. Pain was not associated with lower csPCa detection on targeted cores (p=0.23 and p=0.47 depending on csPCa definition). On multivariate analysis, age (OR 0.96, 95% CI 0.94-0.99) and severe anxiety (OR 2.99, 95% CI 1.83-4.89) were a protective and risk factor respectively, for severe biopsy pain. Procedural time was also associated with an increased risk of experiencing severe biopsy pain (OR 1.04, 95% CI 1.00-1.08). If aiming to test possible anxiety preventive measures effects on pain, an anxiety cut off >6 NRS would decrease to 13% the number of patients being treated whilst identifying 56% of those experiencing severe pain. CONCLUSIONS: TPFBx under LA yield moderate pain. Pain does not influence csPCa target detection. Patients anxiety predicts pain. A NRS-based anxiety assessment may be used to identify those at higher risk of experiencing severe pain in men undergoing TPFBx.
BACKGROUND: Several TP biopsy series proved feasibility under LA. However, there is a lack of large analysis detailing pain outcomes and factors influencing pain. MATERIALS AND METHODS: From 2016 to 2019 we performed a multicenter prospective study in men undergoing mpMRI-TPFBx (target+systematic cores) under LA. Primary outcomes were: i) pain scores (assessed through a 0-10 point NRS); ii) identification of factors associated with severe pain. Secondary outcome was to evaluate pain influence on csPCa target cores detection. RESULTS: We included 1,008 men undergoing TPFBx under LA. Mean NRS pain scores were 3.9±2.1 at LA administration, 3.1±2.3 when performing Bx. Pain was not associated with lower csPCa detection on targeted cores (p=0.23 and p=0.47 depending on csPCa definition). On multivariate analysis, age (OR 0.96, 95% CI 0.94-0.99) and severe anxiety (OR 2.99, 95% CI 1.83-4.89) were a protective and risk factor respectively, for severe biopsy pain. Procedural time was also associated with an increased risk of experiencing severe biopsy pain (OR 1.04, 95% CI 1.00-1.08). If aiming to test possible anxiety preventive measures effects on pain, an anxiety cut off >6 NRS would decrease to 13% the number of patients being treated whilst identifying 56% of those experiencing severe pain. CONCLUSIONS:TPFBx under LA yield moderate pain. Pain does not influence csPCa target detection. Patientsanxiety predicts pain. A NRS-based anxiety assessment may be used to identify those at higher risk of experiencing severe pain in men undergoing TPFBx.
Authors: Philipp Krausewitz; Helene Schmeller; Julian Luetkens; Darius Dabir; Jörg Ellinger; Manuel Ritter; Rupert Conrad Journal: World J Urol Date: 2022-07-14 Impact factor: 3.661