MP43-15 PROVIDER VARIATION IN PAIN SCORES DURING FREEHAND TRANSPERINEAL PROSTATE BIOPSY UNDER LOCAL ANESTHESIA

Abstract

You have accessJournal of UrologyProstate Cancer: Detection & Screening IV (MP43)1 Sep 2021MP43-15 PROVIDER VARIATION IN PAIN SCORES DURING FREEHAND TRANSPERINEAL PROSTATE BIOPSY UNDER LOCAL ANESTHESIA Ajith Dupati, Ji Qi, Stephanie Ferrante, John M. DiBianco, Adam Walker, John T. Wei, Chandy Ellimoottil, Lindsey A. Herrel, Richard C. Wu, Arvin K. George, and Brian R. Stork Ajith DupatiAjith Dupati More articles by this author , Ji QiJi Qi More articles by this author , Stephanie FerranteStephanie Ferrante More articles by this author , John M. DiBiancoJohn M. DiBianco More articles by this author , Adam WalkerAdam Walker More articles by this author , John T. WeiJohn T. Wei More articles by this author , Chandy EllimoottilChandy Ellimoottil More articles by this author , Lindsey A. HerrelLindsey A. Herrel More articles by this author , Richard C. WuRichard C. Wu More articles by this author , Arvin K. GeorgeArvin K. George More articles by this author , and Brian R. StorkBrian R. Stork More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002064.15AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Transperineal prostate (TP) biopsy minimizes the risk of post-biopsy infectious complications. We aim to examine provider-level variation and factors associated with pain/discomfort during TP biopsy. METHODS: A standardized, immediate post-procedure patient-reported survey was administered to men undergoing TP biopsy. Patient-reported pain overall and for each subdomain including positioning, probe insertion, anesthetic administration, and prostate sampling were evaluated using the validated Wong-Baker FACES pain scale. Bivariate analyses were performed to determine association of age, race, BMI, and Charlson Comorbidity Index (CCI) with pain during biopsy. Provider-level variation was assessed for overall pain and at each portion of the procedure among urologists who performed at least 10 biopsies. RESULTS: A total of 198 patients undergoing TP biopsy with 8 urologists completed the survey. The median score for overall pain during the procedure was 4 (IQR 2-5), and anesthetic administration demonstrated the highest pain scores across all the subdomains (Median=3 [IQR 2-6]). Age, race, BMI, and CCI score were not significantly associated with overall pain scores. Provider-level variation for overall pain during TP biopsy is presented in Figure 1. Only during local anesthetic administration was significant variation observed across providers (Figure 2, p=0.012). CONCLUSIONS: In-office freehand TP biopsy under local anesthesia is well tolerated with only mild to moderate discomfort. Significant variation in pain scores during administration of local anesthesia exists between providers. Standardization and optimization of local anesthetic technique appears to offer the greatest opportunity to reduce patient reported pain scores during biopsy. Source of Funding: Data collected through the Michigan Urological Surgery Improvement Collaborative (MUSIC) which is funded by Blue Cross Blue Shield of Michigan (BCBSM) © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e787-e788 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ajith Dupati More articles by this author Ji Qi More articles by this author Stephanie Ferrante More articles by this author John M. DiBianco More articles by this author Adam Walker More articles by this author John T. Wei More articles by this author Chandy Ellimoottil More articles by this author Lindsey A. Herrel More articles by this author Richard C. Wu More articles by this author Arvin K. George More articles by this author Brian R. Stork More articles by this author Expand All Advertisement Loading ...