Westenberg A M, Cossar E H, Lorimer L B, Costello J P
Urology Department, Wellington Hospital.
N Z Med J. 1999 Jun 25;112(1090):231-2.
The suspicion of prostatic adenocarcinoma requires confirmatory biopsy of the prostate. The transrectal ultrasound scanner (TRUS) allows visualisation of the prostate and accurate placement of the biopsy needle. Traditionally this procedure has been performed under general anaesthetic. More recently however, there has been a trend to carry out TRUS and biopsy without anaesthetic. The acceptability of this procedure has never been formally investigated in a New Zealand population. The aim of this study was to determine the acceptability of TRUS and prostatic biopsy without anaesthesia.
One hundred consecutive patients undergoing TRUS guided prostatic biopsy without anaesthetic were included in the study. The indications for biopsy were an elevated serum prostate-specific antigen or an abnormal gland on digital rectal examination. The procedure was performed by the same surgeon on each occasion, using the same equipment (6 MHz multiplanar transrectal probe with 18 gauge biopsy needle) and standard techniques (left lateral position, sextant biopsies). The patients were contacted by telephone a minimum of three months after the procedure and were asked a set of standardised questions about their experience.
Seventy-nine percent of patients found the procedure only slightly, or not at all, uncomfortable. Despite the fact that 21% of the patients would prefer the same technique (no anaesthetic) if they were to require a further biopsy. Those patients who felt that they would prefer a general anaesthetic if they had to have a future biopsy were on average younger and had a significantly higher discomfort score.
Transrectal ultrasound scanning and biopsy without anaesthetic is well tolerated by New Zealand men.
怀疑前列腺腺癌时需要对前列腺进行确诊性活检。经直肠超声扫描仪（TRUS）可实现前列腺可视化并精确放置活检针。传统上，该操作是在全身麻醉下进行的。然而，最近出现了一种在无麻醉情况下进行经直肠超声检查和活检的趋势。在新西兰人群中，从未对该操作的可接受性进行过正式研究。本研究的目的是确定在无麻醉情况下经直肠超声检查和前列腺活检的可接受性。
本研究纳入了100例连续接受无麻醉经直肠超声引导下前列腺活检的患者。活检指征为血清前列腺特异性抗原升高或直肠指检发现腺体异常。每次操作均由同一位外科医生进行，使用相同的设备（带有18号活检针的6兆赫多平面经直肠探头）和标准技术（左侧卧位，六分区活检）。在术后至少三个月通过电话联系患者，并询问他们一系列关于其经历的标准化问题。
79%的患者认为该操作只是稍有不适或根本没有不适。尽管有21%的患者如果需要再次活检会选择相同的技术（无麻醉）。那些认为如果未来必须进行活检会选择全身麻醉的患者平均年龄较小，且不适评分显著更高。
新西兰男性对无麻醉的经直肠超声扫描和活检耐受性良好。
