The potential of real-time ultrasound screen viewing to reduce pain and anxiety symptoms during transperineal prostate biopsy under local anesthesia: a prospective non-randomized observational study.

BACKGROUND

To explore the possible impact of real-time ultrasound screen visualization on pain perception, anxiety levels, and overall patient experience during transperineal prostate biopsy (TPBx) performed under local anesthesia.

MATERIALS AND

METHODS

The prospective observational study was conducted at two medical centers. Patients were allocated into two groups: a control group (n = 59), which did not receive visual feedback, and a display group (n = 63), which observed the ultrasound screen with concurrent procedural explanations. Pain was assessed using the Visual Analog Scale (VAS), while anxiety levels were measured with the Spielberger State-Trait Anxiety Inventory (STAI) and Beck Anxiety Inventory (BAI). Patient satisfaction and willingness to undergo repeat biopsies were also evaluated.

RESULTS

A total of 122 patients were included. The display group reported significantly lower overall procedural pain (VAS: 2.46 ± 1.28 vs. 3.08 ± 1.49, p = 0.005) and reduced post-procedure anxiety (STAI-1: 44.6 ± 8.8 vs. 49.5 ± 9.2, p = 0.001). Additionally, patient satisfaction scores were significantly higher in the display group (8.00 [6-9] vs. 5.00 [4-7], p < 0.001), along with an increased willingness to undergo repeat biopsy (8.00 [4-10] vs. 5.00 [2-8], p = 0.002).

CONCLUSION

Real-time ultrasound screen viewing during TPBx under local anesthesia was associated with statistically significant reductions in pain and anxiety scores. However, considering the study's non-randomized design and the modest magnitude of VAS change, the clinical relevance of this difference should be interpreted with caution. This simple and low-cost approach may help improve patient comfort and procedural compliance, but further randomized studies are needed to confirm its effectiveness.