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What do patients think about trans-perineal biopsy of prostate under LA?!

Mostafa Shendy

Mostafa Shendy1, Anna McClune2, Marius Craciun3, Javle Lorraine4
1Royal Glamorgan hospital, Cardiff, United Kingdom. 2Leighton hospital, Crewe, United Kingdom. 3LEIGHTON hospital, Crewe, United Kingdom. 4Leightonhospital, Crewe, United Kingdom



Transperineal biopsy of the prostate (TP biopsy) is now the gold standard, increasingly performed under local anesthesia (LA) instead of general anesthesia (GA). This shift enhances accessibility and reduces risks, allowing outpatient settings. Our study evaluates patient experiences with TP biopsy to improve tolerability and promote its use under LA.


We conducted a prospective meta-analysis of 108 patients undergoing TP prostate biopsy under LA in a UK regional hospital from February 2021 to July 2023. Patients completed a TP biopsy tolerability questionnaire immediately post-procedure and seven days later. The questionnaire comprised 10 questions assessing discomfort during the procedure, probe insertion, LA injection, biopsy needle insertion, overall pain, embarrassment, future biopsy concerns, and comparison to previous transrectal biopsies.


Among 108 patients, discomfort scores for probe insertion (3), probe presence (3), LA injection (3.58), and biopsy needle insertion (3.72) (as 0 is none, and 10 is a great deal) Overall pain and embarrassment scores averaged 1.2 and 0.75, respectively(as 0 is not at all, 1 is a little, 2 is somewhat, and 3 is a lot), with 79 patients reporting minor or no issues and 25 reporting moderate problems. Most patients (106) found the procedure tolerable under LA. 27 patients had prior transrectal biopsies, with 17 preferring TP biopsy and 4 finding no difference.


TP prostate biopsy is tolerable under LA, with moderate discomfort and low pain and embarrassment levels reported by most patients. Proper counseling on GA availability remains crucial despite the procedure’s tolerability under LA.