Objectives: To compare pain during prostate biopsy performed in two different positions. Methods: We carried out a prospective, randomized study to compare the pain experienced during biopsy in two different positions: lithotomy (group 1) and lateral (group 2). Pain was evaluated using a visual analog scale (VAS). Results: 70 patients were randomized to the two positions for biopsy. The median number of samples taken was the same for both groups (n = 10). The median VAS rating after biopsy was 30 in group 1 and 45 in group 2. 96.6% of the men in group 1 were prepared to undergo a repeat examination according to the same modalities, against only 86.7% in group 2. Only 14.3% of the men in group 1 would have preferred more analgesic against 37.1% in group 2. Pain after biopsy was less in group 1. The men with prostate adenocarcinoma tolerated biopsies better than the others. Conclusion: Our results suggest that the lithotomy position induced less pain and less post-biopsy hematuria than did the lateral position during prostate biopsy. Men with prostate adenocarcinoma tolerated the procedures better.

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