AcuTENS for Pain Relief During TRUS-Guided Prostate Biopsy

NCT ID: NCT07292337

Last Updated: 2025-12-24

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

ACTIVE_NOT_RECRUITING

Clinical Phase

NA

Total Enrollment

53 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-12-01

Study Completion Date

2026-11-30

Brief Summary

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This study evaluates whether transcutaneous electrical nerve stimulation applied at specific acupuncture points (AcuTENS) can reduce pain and anxiety during transrectal ultrasound-guided prostate biopsy for participants suspected of prostate cancer. Many patients experience significant discomfort despite the use of periprostatic nerve block (PPNB).

The aim of this study is to determine whether AcuTENS provides additional pain relief or anxiety reduction beyond standard analgesia. The findings may help identify a simple, low-risk adjunct that can improve patient comfort during prostate biopsy. AcuTENS is a non-invasive technique that delivers mild electrical stimulation through the skin, targeting acupuncture points believed to modulate pain perception.

In this randomized, double-blind, placebo-controlled trial, participants are assigned to receive either active AcuTENS or a placebo TENS device that produces no therapeutic stimulation . All participants with receive routine care, including PPNB, according to institutional protocol. Pain scores, anxiety levels, vital signs, and patient satisfaction are recorded before, during, and after the biopsy.

Detailed Description

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Transrectal ultrasound-guided prostate biopsy is the standard diagnostic procedure for suspected prostate cancer. Despite routine analgesic strategies such as periprostatic nerve block, many patients continue to experience moderate pain and procedure-related anxiety.

AcuTENS, a form of transcutaneous electrical nerve stimulation applied to acupuncture points, has shown potential benefits in chronic pain conditions, osteoarthritis, and procedural discomfort in small-scale studies. Its proposed mechanism involves activation of peripheral nerve fibers, endogenous opioid pathways, and autonomic modulation, leading to reduced pain perception and improved relaxation. However, high-quality randomized controlled data for its use during prostate biopsy are limited.

This study is a randomized, double-blind, placebo-controlled clinical trial conducted at University Malaya Medical Centre. The trial consists of two arms:

1. Active AcuTENS: Electrical stimulation applied to predetermined acupuncture points before and during the biopsy.
2. Placebo TENS: Identical device with no therapeutic electrical output.

An initial pilot phase involving 10 patients demonstrated that AcuTENS was feasible, safe, and potentially beneficial. This informed the development of the current definitive trial, which includes 53 participants.

All participants undergo the standard TRUS-guided prostate biopsy with local anesthesia using PPNB. Pain (VAS), anxiety (standardized scales), heart rate, blood pressure, and patient satisfaction are assessed at predefined time points.

The primary outcome is assessment of pain during insertion of ultrasound probe, injection of local anaesthesia and pain during collection of biopsy. Secondary outcomes include anxiety reduction, hemodynamic stability, satisfaction scores, and any adverse effects related to TENS use.

This investigation aims to determine whether AcuTENS offers meaningful improvement in patient comfort during prostate biopsy. If effective, it could be incorporated into routine practice as a simple, safe, and affordable adjunct to existing analgesic measures.

Conditions

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Prostate Cancer Procedural Pain Relief TRANSRECTAL ULTRASOUND-GUIDED PROSTATE BIOPSY Transcutaneous Electrical Nerve Stimulation

Keywords

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Transcutaneous electrical nerve stimulation TRUS-guided prostate biopsy Pain control and anxiety management during procedure

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Randomized 1:1 parallel-group design comparing interventional group using active AcuTENS with placebo TENS during TRUS-guided prostate biopsy.
Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors
Participants and all study personnel, including clinicians performing the biopsy and assessors recording outcomes, are blinded to group allocation. Intervention devices are identical in appearance.

Study Groups

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Active AcuTENS

Participants receive active transcutaneous electrical nerve stimulation applied to selected acupuncture points before and during TRUS-guided prostate biopsy, in addition to standard periprostatic nerve block.

Group Type EXPERIMENTAL

Active AcuTENS

Intervention Type DEVICE

Electrical stimulation delivered via surface electrodes placed on predefined acupuncture points. Stimulation is applied before and during the biopsy using a device capable of therapeutic current output.

Placebo TENS

Participants receive a identical TENS device with a placebo setting and no therapeutic electrical output, applied to the same acupuncture points before and during TRUS-guided prostate biopsy, in addition to standard periprostatic nerve block.

Group Type PLACEBO_COMPARATOR

Placebo TENS

Intervention Type DEVICE

An identical TENS device set to a placebo setting with no active electrical output. Electrodes are applied to the same acupuncture points, with no therapeutic stimulation.

Interventions

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Active AcuTENS

Electrical stimulation delivered via surface electrodes placed on predefined acupuncture points. Stimulation is applied before and during the biopsy using a device capable of therapeutic current output.

Intervention Type DEVICE

Placebo TENS

An identical TENS device set to a placebo setting with no active electrical output. Electrodes are applied to the same acupuncture points, with no therapeutic stimulation.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

1. Patient consented for first time TRUS prostate biopsy.
2. Patient aged 18 years and above.

Exclusion Criteria

1. Patient with previous experience of TRUS biopsy
2. Patient with pacemakers or automatic cardiac defibrillator implant or implant in the upper limb
3. Patient with cutaneous skin breaks on application sites (e.g wound, burn scar)
4. Patient diagnosed to have epilepsy or impaired mental state or anxiety disorder
5. Patient with known allergy to acupuncture patch or lidocaine spray
Minimum Eligible Age

18 Years

Eligible Sex

MALE

Accepts Healthy Volunteers

No

Sponsors

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University of Malaya

OTHER

Sponsor Role lead

Responsible Party

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Harshini Mahendran

Research Team member

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Dr Novinth Kumar A/L Raja Ram, MBBS, MS (Gen Surg)

Role: PRINCIPAL_INVESTIGATOR

Department of Surgery (Urology Unit), University Malaya Medical Centre, Kuala Lumpur, Malaysia

Locations

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University of Malaya

Kuala Lumpur, Kuala Lumpur, Malaysia

Site Status

Countries

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Malaysia

References

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Nazir B. Pain during transrectal ultrasound-guided prostate biopsy and the role of periprostatic nerve block: what radiologists should know. Korean J Radiol. 2014 Sep-Oct;15(5):543-53. doi: 10.3348/kjr.2014.15.5.543. Epub 2014 Sep 12.

Reference Type RESULT
PMID: 25246816 (View on PubMed)

Ouzounidis X, Moysidis K, Kalinderis N, Papanikolaou D, Koukourikis P, Papaefstathiou E, Hatzimouratidis K. Efficacy and safety of three different analgesic methods for patients undergoing transrectal ultrasound-guided prostate biopsy: a prospective, randomized controlled trial. Hippokratia. 2020 Oct-Dec;24(4):166-172.

Reference Type RESULT
PMID: 35023892 (View on PubMed)

Related Links

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Other Identifiers

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UMG012C-2024

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

UMG012C-2024

Identifier Type: -

Identifier Source: org_study_id