Location of prostate biopsy determines pain level

Location may be everything when it comes to the pain associated with prostate biopsy.

According to a recent study from the Mayo Clinic, Rochester, MN, taking tissue samples in certain locations tested in the biopsy is more likely to cause pain. Researchers also found that injection of lidocaine to dull pain during the biopsy causes more pain than the insertion of the transrectal ultrasound probe, and that approximately 16% of men who undergo a biopsy experience a moderate or higher level of pain.

The study’s findings were presented at the AUA North Central Section annual meeting in San Diego.

“We found we cannot predict who will have higher levels of pain at the time of a prostate biopsy, simply based on the patient’s history and features,” said lead investigator Richard Ashley, MD. “We discovered the location of biopsy was the most predictive of higher pain scores, not age, body mass index, family history, presence of cancer, inflammation, whether a lump was palpable, or whether the prostate was large or small.”

Specifically, biopsy of the prostate apex was more painful than biopsy of the prostate base.

The investigators also found that anesthesia administered by direct infiltration of the prostate apex and the surrounding rectal tissues may provide better pain control during a prostate biopsy than do other anesthetic methods.