Effect of Diaphragmatic Breathing on Procedural Anxiety During Transrectal Prostate Biopsy

Abstract Objective To improve the tolerability of transrectal ultrasound guided prostate biopsy through use of diaphragmatic breathing. Methods Forty-seven patients, aged 52 to 79 years, who were scheduled for a TRUS-biopsy with or without MRI guidance, were recruited at a single Veterans Affairs medical center for the diagnosis or evaluation of prostate cancer. Patients either met with a health psychologist for a one-time, diaphragmatic breathing intervention immediately prior to their biopsy, or received usual care. All biopsies were performed using local anesthetic without sedation or anxiolytic therapy. The primary outcome was the difference in self-reported procedural situational anxiety as measured with the State Trait Anxiety Inventory, assessed both pre and post TRUS-biopsy. We also examined secondary outcomes including physiologic parameters (heart rate and blood pressure). Results There were no significant differences in pre-procedural anxiety or physiological parameters between patients who received the intervention and those who received usual care. Patients who received the intervention had a significantly larger decrease in situational anxiety from pre-to-post procedure (M = 14.15, SD = 6.64) compared with those who received usual care (M = 3.45, SD = 9.97); t (38) = -4.0, p Conclusions A guided diaphragmatic breathing intervention reduced procedural anxiety during prostate biopsy and improved patient experience.