Korean J Urol.  2015 Jun;56(6):449-454. 10.4111/kju.2015.56.6.449.

Effect of patient position on pain scales during transrectal ultrasound-guided prostate biopsy

• Kim YU
• Ji YS
• Ko YH
• Song PH

• KMID: 2160585
• DOI: http://doi.org/10.4111/kju.2015.56.6.449

Abstract

PURPOSE
Transrectal ultrasound (TRUS)-guided prostate biopsy is the most useful technique for the diagnosis of prostate cancer; however, many patients describe the procedure as uncomfortable and painful. We investigated the effect of the patient's position on pain scales during TRUS-guided prostate biopsy.
MATERIALS AND METHODS
Between July 2012 and June 2013, a total of 128 consecutive patients who underwent TRUS-guided prostate biopsy were included in this study. Seventy patients underwent the procedure in the lithotomy position performed by a urologist and the other patients (n=58) underwent the procedure in the left lateral decubitus (LLD) position performed by a radiologist. Pain was assessed by using visual analogue scale (VAS) scores from 0 to 10. Using a linear regression model, we analyzed the correlation between pain scale score and clinical variables with a focus on patient position.
RESULTS
No significant differences related to age, body mass index, prostate volume, prostate-specific antigen (PSA), hematuria, pyuria, International Prostate Symptom Score, or the cancer detection rate were observed between the lithotomy and the LLD groups. In the correlation analysis, VAS score showed a significant correlation with diabetes mellitus, PSA level, and lithotomy position (p<0.05). In the multiple linear regression model, VAS score showed a significant correlation with lithotomy position (beta=-0.772, p=0.003) and diabetes mellitus (beta=-0.803, p=0.033).
CONCLUSIONS
We suggest that the lithotomy position may be the proper way to reduce pain during TRUS-guided prostate biopsy.

Keyword

Biopsy; Pain; Patient positioning

MeSH Terms

Aged
Biopsy, Needle/*adverse effects/methods
Humans
Male
Middle Aged
Pain/etiology/*prevention & control
Pain Measurement/methods
Patient Positioning/*methods
Posture/physiology
Prostatic Neoplasms/*pathology
Retrospective Studies
Ultrasonography, Interventional/methods

Figure

• 

  Fig. 1 Simple linear regression model of relationship between visual analogue scale (VAS) score and position. LLD, left lateral decubitus. r2=0.051, p=0.011.

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