{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T21:17:30Z","timestamp":1783459050186,"version":"3.55.0"},"reference-count":33,"publisher":"Wiley","issue":"S2","license":[{"start":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T00:00:00Z","timestamp":1767830400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T00:00:00Z","timestamp":1767830400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine whether subcutaneous local anaesthesia (LA) infiltration at perineal puncture sites reduces immediate postoperative pain after transperineal (TP) prostate biopsy performed under general anaesthesia (GA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this two\u2010centre, patient\u2010blinded, randomised, placebo\u2010controlled trial, men undergoing TP prostate biopsy under GA (GATP biopsy) were allocated 1:1 to receive either 20\u2009mL 0.5% bupivacaine or 20\u2009mL normal saline, infiltrated subcutaneously into the perineal skin at the conclusion of biopsy. The primary endpoint was the proportion of patients reporting moderate\u2010to\u2010severe pain (visual analogue scale [VAS]\u2009score &gt;\u20093) 30\u2009min postoperatively. Secondary endpoints included the Short\u2010Form McGill Pain Questionnaire (SF\u2010MPQ) and opioid use in recovery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 150 men randomised, 140 were included in the modified intention\u2010to\u2010treat analysis. Moderate\u2010to\u2010severe pain occurred in 22.5% of controls and 8.7% of patients receiving LA (absolute risk reduction 13.8%, 95% confidence interval 2.1\u201325.6;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.035; number needed to treat\u2009=\u20097). The median VAS and SF\u2010MPQ scores were 0 in both groups. Opioid administration did not differ significantly (10% control vs 19% LA;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.15). In an exploratory\n                      <jats:italic>post hoc<\/jats:italic>\n                      subgroup, the benefit of LA infiltration was greater among men undergoing &gt;20\u2010core biopsy (34.1% vs 10.6%). No significant complications occurred.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Subcutaneous LA infiltration significantly reduces immediate moderate\u2010to\u2010severe pain following GATP biopsy. Although overall pain scores were low, a clinically meaningful subset benefitted from this simple, low\u2010cost, and safe intervention. These findings also have relevance to contemporary TP prostate biopsy under LA workflows, supporting the concept that superficial infiltration may provide additive value alongside established block\u2010based analgesic protocols.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bju.70135","type":"journal-article","created":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T09:13:47Z","timestamp":1767863627000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Subcutaneous local anaesthetic after transperineal prostate biopsy under\n                    <scp>general anaesthesia<\/scp>\n                    : a randomised trial"],"prefix":"10.1111","volume":"138","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6234-3522","authenticated-orcid":false,"given":"Abdullah","family":"Al\u2010Khanaty","sequence":"first","affiliation":[{"name":"Department of Surgery and Department of Urology, Austin Health The 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