Are Clinically Significant Cancer Detection Rates Different in Peripheral Zone Lesions Undergoing Transrectal MR-TRUS Targeted Prostate Biopsy with Local Anesthesia and Sedoanalgesia?

Objective: We aimed to compare clinically significant prostate cancer (csPC) detection rates between patients who underwent targeted prostate biopsy under sedoanalgesia and those who underwent biopsy under local anesthesia with intrarectal local anesthetic instillation (IRLI). Materials and Methods: We analyzed targeted biopsy data from 2015 to 2021 at our center. csPC detection rates of sedoanalgesia (n=56) and IRLI (n=257) groups in targeted biopsy in peripheral zone (PZ) lesions compared after Mahalanobis distance matching within the propensity score caliper method. Four variablesage, prostate specific antigen density, index lesion prostate imaging-reporting and data system score, and the number of lesions-were selected as covariates for the matching procedure. Results: After matching, 96 patients from the IRLI group and 50 patients from the sedoanalgesia group were included in the analysis. In the IRLI group, csPC was detected in 33 (34.4%) patients, whereas in the sedoanalgesia group, it was detected in 21 (42%) patients. No statistically significant difference was found between the two groups (p=0.365). Conclusions: csPC detection rates for local and sedoanalgesia are similar in PZ lesions while performing targeted transrectal biopsy.