Is the pain level of patients affected by anxiety during transrectal prostate needle biopsy?

Objective. To investigate the effect of anxiety on the pain level of patients during transrectal prostate needle biopsy. Material and methods. A total of 160 consecutive patients underwent prostate biopsy. Group 1 consisted of 86 patients who received bilateral periprostatic infiltration of 5 cm(3) of 2% lidocaine. Group 2 included 74 patients and they received bilateral periprostatic infiltration of 5 cm3 of 0.9% saline solution. The Stait-Trait Anxiety Inventory was administered before the biopsy. The patients' mean pain scores were assessed by means of a visual analog scale (VAS) during digital rectal examination, probe insertion and biopsy. Results. The mean age of the patients was 67.8 years (range 46-79 years). When the two groups were compared regarding the level of pain during DRE and probe insertion, no significant differences were found. The mean VAS score for biopsy was significantly lower in Group 1. In Group 1, the mean VAS scores were similar in patients with no and moderate trait anxiety levels. However, the mean VAS score was significantly higher in patients who had severe trait anxiety than in the others (p=0.002). In Group 2, the differences in VAS scores reached statistical significance between no and moderate, no and severe, and moderate and severe trait anxiety levels (p=0.001). When the state anxiety levels were considered, the mean VAS scores were significantly higher in patients with severe state anxiety scores in Groups 1 and 2 (p=0.003 and 0.001, respectively). Conclusion. We found a significant relationship between trait and state anxiety levels and pain scores in patients who underwent transrectal prostate needle biopsy.