A prospective study on pain score with transperineal prostatic gold seed fiducial implantation under local anesthetic alone

Authors

  • Colin I. Tang Radiation Oncology Department, Calvary Mater Newcastle, Australia; and University of Newcastle, Australia
  • Perakaa Sethukavalan Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON; and University of Waterloo, Waterloo, ON
  • Patrick Cheung Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON; and University of Toronto, Toronto, ON
  • Gerard Morton Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON; and University of Toronto, Toronto, ON
  • Geordi Pang Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON; and University of Toronto, Toronto, ON
  • D. Andrew Loblaw Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON; and University of Toronto, Toronto, ON

DOI:

https://doi.org/10.5489/cuaj.823

Abstract

Background: The purpose of this study was to monitor patient pain score with transperineal prostatic gold seed implantation in the absence of conscious sedation.

Methods: All patients who were scheduled for image-guided external beam radiation (IGRT) and referred for gold seed fiducials were eligible to participate. Gold seed implants were performed by two radiation oncologists between December 2007 and April 2008. Patients received only local and deep anesthetic. No patients had prophylactic IV cannulation for the procedure. Three gold seeds were inserted transperineally into the prostate. A visual analogue scale from 0 to 10 was used to assess the pain at baseline, local and deep anesthetic infiltration, with each seed drop, and after the completion of the procedure.

Results: A total of 30 patients were accrued to this study. The highest recorded increase in pain score was at the time point of deep local anesthesia, at which the mean pain score was 3.8. The mean pain scores at each seed drop were 0.8 (standard deviation [SD]=1.24), 1 (SD=1.26), and 0.5 (SD=0.90), respectively. All gold seed insertion procedures were well-tolerated, with no patient shaving significant pain post-procedure, and no significant procedural complications. There were only slight increases in dysuria, urinary frequency, constipation, urinary retention and flatulence in 7 patients – none of which required intervention.

Interpretation: Transperineal ultrasound-guided gold seed implantation without conscious sedation is well-tolerated and associated with a low complication rate. It is a convenient outpatient procedure obviating the need for resource intensive postoperative monitoring.

Downloads

Download data is not yet available.

Downloads

Published

2013-04-16

How to Cite

Tang, C. I., Sethukavalan, P., Cheung, P., Morton, G., Pang, G., & Loblaw, D. A. (2013). A prospective study on pain score with transperineal prostatic gold seed fiducial implantation under local anesthetic alone. Canadian Urological Association Journal, 7(3-4), e202–6. https://doi.org/10.5489/cuaj.823

Issue

Vol. 7 No. 3-4 (2013): CUAJ April

Section

Original Research

License

You, the Author(s), assign your copyright in and to the Article to the Canadian Urological Association. This means that you may not, without the prior written permission of the CUA:

  • Post the Article on any Web site
  • Translate or authorize a translation of the Article
  • Copy or otherwise reproduce the Article, in any format, beyond what is permitted under Canadian copyright law, or authorize others to do so
  • Copy or otherwise reproduce portions of the Article, including tables and figures, beyond what is permitted under Canadian copyright law, or authorize others to do so.

The CUA encourages use for non-commercial educational purposes and will not unreasonably deny any such permission request.

You retain your moral rights in and to the Article. This means that the CUA may not assert its copyright in such a way that would negatively reflect on your reputation or your right to be associated with the Article.

The CUA also requires you to warrant the following:

  • That you are the Author(s) and sole owner(s), that the Article is original and unpublished and that you have not previously assigned copyright or granted a licence to any other third party;
  • That all individuals who have made a substantive contribution to the article are acknowledged;
  • That the Article does not infringe any proprietary right of any third party and that you have received the permissions necessary to include the work of others in the Article; and
  • That the Article does not libel or violate the privacy rights of any third party.