Minimizing Pain and Optimizing Patient Experience During Prostate Biopsy

  • J. Stephen Jones
Part of the Current Clinical Urology book series (CCU)


Pain is not a necessary attribute of prostate biopsy. Respect for the patient’s comfort, modesty, and well-being greatly improves his experience. Periprostatic lidocaine injection should be standard for the reduction of pain and discomfort. Lidocaine injection at the basilar “Mount Everest” notch is advocated because of the ease of administration as well as the short learning curve for the procedure. More-experienced surgeons may find injection at the apex more effective. Local anesthesia of the prostate and anus allows for better probe positioning crucial to obtaining diagnostic needle cores especially of the anterior horn region. New residents should be trained to respect the patient’s concerns and administer periprostatic block to minimize the discomfort of transrectal ultrasound biopsy.


periprostatic block visual analog pain scores rectal sensation test Mount Everest sign 


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Copyright information

© Humana Press, a part of Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • J. Stephen Jones
    • 1
    • 2
  1. 1.Department of Regional UrologyCleveland Clinic Glickman Urological and Kidney InstituteUSA
  2. 2.Cleveland ClinicLerner College of Medicine at CWRUCleveland

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