2219 DOES THE ADDITION OF APICAL INJECTION OF LOCAL ANESTHESIA TO BASAL INJECTION DIMINISH PAIN RELATED TO TRANSRECTAL ULTRASOUND GUIDED PROSTATE BIOPSY?
Bibliographic record
Abstract
You have accessJournal of UrologyProstate Cancer: Detection and Screening V1 Apr 20122219 DOES THE ADDITION OF APICAL INJECTION OF LOCAL ANESTHESIA TO BASAL INJECTION DIMINISH PAIN RELATED TO TRANSRECTAL ULTRASOUND GUIDED PROSTATE BIOPSY? Ants Toi, Roy Yang, Hadas Moshonov, Sangeet Ghai, Martin O'Malley, Myles Margolis, Boriah Sreeharsha, Ravi Menezes, Neil Fleshner, and Antonio Finelli Ants ToiAnts Toi Toronto, Canada More articles by this author , Roy YangRoy Yang Toronto, Canada More articles by this author , Hadas MoshonovHadas Moshonov Toronto, Canada More articles by this author , Sangeet GhaiSangeet Ghai Toronto, Canada More articles by this author , Martin O'MalleyMartin O'Malley Toronto, Canada More articles by this author , Myles MargolisMyles Margolis Toronto, Canada More articles by this author , Boriah SreeharshaBoriah Sreeharsha Toronto, Canada More articles by this author , Ravi MenezesRavi Menezes Toronto, Canada More articles by this author , Neil FleshnerNeil Fleshner Toronto, Canada More articles by this author , and Antonio FinelliAntonio Finelli Toronto, Canada More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.2394AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Despite basal regional local anesthetic block during prostate biopsy, many men experience pain radiating to the penis. We set out to determine if the addition of apical injection of local anesthetic to the usual basal injection decreased TRUS-guided prostate biopsy related pain, especially pain radiating to the penis. METHODS This is a prospective randomized REB approved study of consecutive men who consented to a survey of pain experienced at TRUS biopsy. We used an11 point Visual Analog Scale (VAS) ranging from 0 (no pain) to 10 (most severe pain). A 2 point difference in VAS was considered significant. Biopsy procedure consisted of DRE, probe insertion (C9-5 ICT, Philips, Bothell, WA), randomized analgesia injection of 10 mL of 1% lidocaine into the base or base+apex (22 gauge needle), scan, biopsy with 18 gauge needle gun (Bard Magnum, Covington, GA), taking core numbers as needed. Groups were assigned by opening an envelope after probe insertion and before anesthetic injection. The base (B) group received 10 mL injected at the left and right base (5 mL per side). The base+apex (BA) group received 10 mL, 6 mL at the base (3 per side) and 4 cc at the apex (2 on each side of the urethra). Pain scores and immediate and delayed complications were noted. RESULTS 178 men consented, B 89, BA 89. Baseline characteristics were similar with median values as: anxiety (3.9 vs 4.1), age (63.8 vs 65.3 years), prostate volume (44.3 vs 43.6 cc), percent with prior biopsies (42% vs 48%), needle cores taken (12 vs 13). There was no significant difference between B and BA in VAS pain scores at anesthetic injection (1.9 vs 2.2), pelvic pain (1.8 vs 1.9), penile pain (1.5 vs 1.6), degree of pain with higher (>12) numbers of cores (1.7 vs 1.6), overall pain (1.7 vs 1.7), or immediate complications (4.5% vs 2.2%). Late follow up of 67 men revealed sepsis in 2 B and 1 BA, and 1 erectile difficulty in the B group. There was no element where the VAS differed by more than 2 points. CONCLUSIONS Apical paraurethral injection of anesthetic does not significantly diminish overall pelvic or penile pain experienced during TRUS-guided prostate biopsy. There were no differences in complication rates between the two injection patterns. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e895 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ants Toi Toronto, Canada More articles by this author Roy Yang Toronto, Canada More articles by this author Hadas Moshonov Toronto, Canada More articles by this author Sangeet Ghai Toronto, Canada More articles by this author Martin O'Malley Toronto, Canada More articles by this author Myles Margolis Toronto, Canada More articles by this author Boriah Sreeharsha Toronto, Canada More articles by this author Ravi Menezes Toronto, Canada More articles by this author Neil Fleshner Toronto, Canada More articles by this author Antonio Finelli Toronto, Canada More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.172 | 0.047 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".