Increased patient satisfaction from transrectal ultrasonography and biopsy under sedation

Abstract

Objective To determine the acceptability and patient satisfaction of transrectal biopsy undertaken with the patient under sedation. Patients and methods A retrospective questionnaire was sent to 100 patients who had undergone transrectal biopsy between January and August 1998. Levels of patient acceptability and satisfaction were assessed using visual analogue scales (VAS, with a maximum score of 10 being the least satisfactory or acceptable) and direct questions about the side‐effects of the procedure. A subsequent prospective study was undertaken on 130 patients undergoing transrectal biopsy with sedation between January 1999 and January 2000. Results The mean score for patient discomfort with sedation was 1.5, compared with 3.5 with no sedation. The overall satisfaction score improved from 3.1 to 0.9 with sedation. Complication rates were comparable, although slightly higher overall in the prospective group. Conclusion Sedation can significantly reduce patient discomfort and make the transrectal biopsy a more satisfactory experience for the patient. This is particularly important in the proportion of men who need to be considered for repeat biopsies.

Efficacy and cost analysis of transrectal ultrasound-guided prostate biopsy under monitored anesthesia

“…There is a general consensus regarding the necessity of some form of anesthesia during TRUS-guided prostate biopsy due to preoperative pain and/or discomfort. 7,11,12 The most common methods for alleviating discomfort during TRUS-guided biopsy are intrarectal gel or periprostatic injection. 13,14 Periprostatic nerve blocks have been reported to be effective for the reduction in discomfort, but may have limited ability to reduce Prostate biopsy under monitored anesthesia SG Kang et al 725 pain.…”

“…15,16 In addition, nerve blocks do not reduce pain during the insertion of ultrasound probes, and are even associated with increases in pain during repeated needle punctures. 17 Peters et al 7 first reported the use of propofol during prostate biopsy in 2001, but subsequent reports related to this form of sedation did not appear until 2005. This is largely due to the fact that prostate biopsies are considered minor outpatient procedures, as well as the high cost of sedation.…”

“…Peters et al 7 reported that the use of sedation for TRUS-guided biopsy increases healthcare costs and emphasized the need for cost analysis, although they did not conduct cost analyses themselves. In our investigation, compared with the use of lidocaine jelly, the increased costs of sedation with propofol and remifentanil were minimal at about $169, because the national health insurance corporation covers 80% of the overall cost in Korea.…”

“…2,3 Some examples of anesthetics that may be used during TRUS-guided biopsies include intrarectal lidocaine gel, periprostatic nerve blockers, sedation and caudal blockage. [4][5][6] Peters et al 7 reported the first use of propofol during TRUS-guided biopsies, and observed significantly decreased patient discomfort. However, they performed sextant biopsies in different with current extended biopsy methods, and cost was not considered.…”

The measurement of psychological distress in men being investigated for the presence of prostate cancer

“…The study population was referred to our department on clinical grounds, such as a high PSA detected while investigating LUTS, or with abnormal rectal examination findings. We have previously reported an increased patient satisfaction with the use of sedation during TRUS-B, 14 and therefore all men undergoing TRUS-B in our department have propofol sedation prior to their procedure. All patients referred for a TRUS-B under sedation as a day-case procedure were informed of the nature of this study and were consented to complete the questionnaire.…”