Does experimental pain assessment before biopsy predict for pain during transrectal ultrasound-guided prostate biopsy?

摘要

OBJECTIVES: To evaluate whether assessment of experimental pain perception using the modified tourniquet test before a biopsy procedure could predict the pain scores during transrectal ultrasound-guided prostate biopsy. However, the relationship between the experimental pain assessment before prostate biopsy and the pain scores during the biopsy procedure has not been established. METHODS: A total of 67 men who underwent transrectal ultrasound-guided 12-core prostate biopsy were prospectively enrolled in the study. The day before biopsy, a modified submaximal effort tourniquet test was performed on all patients. During the test, pain scores were recorded at 30, 60, 90, and 120 seconds after inflation of the blood pressure cuff. Pain scores were also recorded during probe introduction into the rectum and prostate biopsy. Pain was assessed using a visual analogue scale (VAS). RESULTS: A significant correlation was found between the VAS scores in the tourniquet test and the VAS scores during probe introduction and the VAS scores during prostate biopsy (P <0.0001). The most significant correlation was found between the VAS scores during prostate biopsy and the VAS 60-second scores during the tourniquet test (P <0.0001, r=0.756). No significant relation was found between the VAS scores and age, prostate volume, or prostate-specific antigen level (P >0.05). CONCLUSIONS: Our results have shown that a simple and quick tourniquet test could be useful in identifying those men who will experience greater pain during transrectal ultrasound-guided prostate biopsy. In the light of these data, additional studies will be planned to evaluate whether experimental pain assessment before the procedure could predict the analgesic potency of pain-relieving treatment during prostate biopsy.