Pain Comparison: Transrectal vs. Transperineal Prostate Biopsy

Inclusion Criteria: * Male patients aged 18 years and older Patients with clinical indication for prostate biopsy (elevated serum prostate-specific antigen \[PSA\] level, abnormal digital rectal examination \[DRE\], and/or suspicious lesion on multiparametric prostate magnetic resonance imaging \[mpMRI\]) * Patients undergoing prostate biopsy for the first time * Patients able to understand and complete the Visual Analog Scale (VAS) for pain assessment * Patients who have provided written informed consent to participate in the study Exclusion Criteria: * Patients with a history of previous prostate biopsy * Patients with a previously confirmed diagnosis of prostate cancer * Patients with active urinary tract infection or prostatitis at the time of biopsy * Patients with anorectal pathology that may interfere with the transrectal approach (e.g., anal stenosis, active hemorrhoidal disease, anal fissure, prior rectal surgery) * Patients with perineal pathology that may interfere with the transperineal approach (e.g., perineal infection, scarring, or prior surgery) * Patients with bleeding diathesis or those receiving anticoagulant therapy that cannot be safely discontinued before the procedure * Patients with known allergy or hypersensitivity to local anesthetic agents * Patients with chronic pain syndromes or those receiving regular analgesic or opioid treatment that may affect pain perception * Patients with cognitive impairment, psychiatric disorders, or language barriers …