The following is a summary of “Patient Reported Outcomes of Transperineal Prostate Biopsy With Tumescent Local Anesthesia,” published in the December 2023 issue of Urology by Myrga, et al.

For a study, researchers sought to evaluate the outcomes of transperineal prostate biopsy performed in the office setting using tumescent local anesthesia compared to transrectal biopsy with standard local anesthesia, focusing on patient-reported anxiety, pain, and embarrassment.

Consecutive patients undergoing either transperineal biopsy with tumescent local anesthesia or transrectal biopsy with standard local anesthesia were prospectively enrolled. Tumescent anesthesia involves the use of dilute lidocaine solution administered with a self-filling syringe. Patients rated their pain levels before, during, and after the procedure using a visual analog scale, while anxiety and embarrassment were assessed using the Testing Modalities Index Questionnaire.

From April 2021 to June 2022, 430 patients underwent transperineal biopsy with tumescent anesthesia, while 65 underwent transrectal biopsy. Patients undergoing transperineal biopsy reported significantly higher pain scores than those undergoing transrectal biopsy (3.9 vs. 1.6, P < .01), although these scores decreased to nearly zero immediately post-procedure. Moreover, transperineal biopsy patients experienced higher levels of anxiety (71% vs. 45%, P < .01) and embarrassment (32% vs. 15%, P < .01).

Transperineal biopsy with tumescent anesthesia was found to be safe and well-tolerated. However, patients undergoing this procedure still reported higher procedural pain, anxiety, and embarrassment compared to transrectal biopsy. Further research investigating additional interventions to enhance patient comfort during a transperineal prostate biopsy is warranted.

Reference: goldjournal.net/article/S0090-4295(23)00803-8/abstract