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Comparison of patient comfort between MR-guided in-bore and MRI/ultrasound fusion-guided prostate biopsies within a prospective randomized trial

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Abstract

Purpose

The objective of this study was to compare patient comfort between MR-guided in-bore prostate biopsy (IB-GB) and MRI/ultrasound fusion-guided prostate biopsy (FUS-GB) with additional systematic 12-core transrectal ultrasound (TRUS)-guided biopsy within a prospective randomized trial.

Methods

Two hundred and ten consecutive patients were randomly assigned in a 1:1 ratio to receive either IB-GB and prior intrarectal instillation of a 2 % lidocaine gel (n = 106) or FUS-GB plus additional systematic 12-core TRUS-guided biopsy and prior application of a periprostatic nerve block (PPNB) with 2 % mepivacaine (n = 104). The maximal procedural pain (MPP) on a 0–10 visual analog scale and the operating room time were recorded for each biopsy session.

Results

Baseline characteristics and mean number of targeted biopsy cores (5.6 ± 0.8 vs 5.4 ± 1.2 for IB-GB and FUS-GB, respectively; p = 0.278) were similar in both study arms. In relation to the IB-GB arm, the total number of biopsy cores in the FUS-GB arm, including the systematic 12-core TRUS-guided biopsy, was significantly higher (17.4 ± 1.2; p < 0.001). Patients with IB-GB had significantly higher MPP scores (2.95 ± 2.15) compared with subjects with FUS-GB (1.95 ± 1.56; p < 0.001). FUS-GB required significantly less time (28.22 ± 11.61 min) in comparison with IB-GB (42.09 ± 11.37 min; p < 0.001).

Conclusions

The PPNB can easily be administered just prior to performing FUS-GB. Thus, patients have significantly lower pain levels in comparison with IB-GB, which is usually done with intrarectal anesthetic gels. Although the addition of a systematic 12-core TRUS-guided biopsy significantly increases the number of biopsy cores, FUS-GB still requires significantly less time in comparison with IB-GB.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standard

The present study has been approved by the ethics committee of Heinrich-Heine University Düsseldorf. The study has been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. All patients gave their informed consent prior to their inclusion in the study.

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Authors and Affiliations

  1. Department of Urology, Medical Faculty, University of Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany

    Christian Arsov, Robert Rabenalt, Andreas Hiester & Peter Albers

  2. Department of Diagnostic and Interventional Radiology, Medical Faculty, University of Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany

    Michael Quentin, Dirk Blondin, Gerald Antoch & Lars Schimmöller

Authors
  1. Christian Arsov
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  2. Robert Rabenalt
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  3. Michael Quentin
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  4. Andreas Hiester
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  5. Dirk Blondin
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  6. Peter Albers
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  7. Gerald Antoch
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  8. Lars Schimmöller
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Correspondence to Christian Arsov.

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Arsov, C., Rabenalt, R., Quentin, M. et al. Comparison of patient comfort between MR-guided in-bore and MRI/ultrasound fusion-guided prostate biopsies within a prospective randomized trial. World J Urol 34, 215–220 (2016). https://doi.org/10.1007/s00345-015-1612-6

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  • DOI: https://doi.org/10.1007/s00345-015-1612-6

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