Less painful prostatic biopsies and 'Painfree TRUS B'

Alfred urologist and Central Clinical School Adjunct Clinical A/Prof Jeremy Grummet is lead investigator of an ANZUP team conducting a study looking at pain relief for prostate biopsy. ANZUP is the peak body for conducting clinical research on urological cancers in Australia and New Zealand and A/Prof Grummet's team was awarded an NHMRC grant of nearly $600,000 to run this multi-centre trial.

The study, called 'Painfree TRUS B' (which rhymes), is a double-blinded randomised trial comparing the standard method of pain relief for a transrectal ultrasound-guided (TRUS) prostate biopsy with a novel approach of analgesia.

TRUS biopsy is usually performed with local anaesthetic infiltration of the tissue around the prostate. However, sometimes this doesn't provide enough numbing, nor does it address the discomfort of the initial passage of the transrectal probe. As a result, many men find TRUS biopsy a painful and distressing experience.

This trial, which started accruing patients in December 2015, compares the standard approach of local anaesthetic with local anaesthetic plus the addition of a Penthrox inhaler, which acts as a systemic painkiller. Penthrox inhalers have been used by paramedics in the field in Australia for many years and appear to be safe and effective. They have only recently been approved for use in minor procedures in hospital.

A/Prof Grummet is also site investigator of another ANZUP randomised trial running at the Alfred on the use of BCG with Mitomycin for bladder cancer.