Luján Galán M, Páez Bordá A, Fernández González I, Romero Cajigal I, Gómez de Vicente J M, Berenguer Sánchez A
Servicio de Urología, Hospital Universitario de Getafe, Madrid.
Actas Urol Esp. 2001 Jan;25(1):46-9. doi: 10.1016/s0210-4806(01)72565-x.
Prostate biopsy is a basic step towards prostate cancer (Pca) diagnosis, but usually not free from complications. In this article we have reviewed the adverse effects of this procedure in our setting.
We studied in a prospective fashion the complications arising from transrectal prostate biopsy with the aid of a questionnaire fulfilled by 303 patients who underwent this procedure, within the context of a Pca screening program. All biopsies were transrectal ultrasound guided and randomly taken (sextant). A cleaning enema was applied the night before, and 100 mg of intramuscular tobramycin were administered prior of the procedure.
Ninety patients (29.7%) had no adverse effects at all, and 136 (44.9%) reported at least one minor complication (hematuria, hemospermia, or autolimited dysuria). Lastly 77 (25.4%) presented with major complications--urinary retention, fever, need for medical assistance (primary or hospital care) or treatment. Thirty-five patients (11.5%) reported to present with fever after biopsy, 145 (47.8%) hematuria, 95 (31.3%) hemospermia, 77 (25.4%) rectal bleeding, 67 (22.1%) urinary difficulty, and 9 (2.9%) urinary retention. Up to 39 (12.8%) needed to visit their G.P., and 19 of them were referred to Hospital, where only 6 (1.9%) were admitted longer than 24 hours. No intensive care unit admittances or deaths were reported.
The rate of post-transrectal biopsy adverse effects is high in our experience. This phenomenon could be explained, in part, due to data collecting by means of a self-administered questionnaire. Probably the high fever rate presented here could be diminished with other type of antibiotic prophylaxis.
前列腺活检是前列腺癌（Pca）诊断的基本步骤，但通常并非没有并发症。在本文中，我们回顾了该操作在我们研究环境中的不良反应。
在一项前列腺癌筛查项目中，我们以前瞻性方式研究经直肠前列腺活检引起的并发症，借助303例接受该操作的患者填写的问卷进行研究。所有活检均在经直肠超声引导下随机取材（六分区）。术前一晚进行清洁灌肠，并在操作前给予100mg肌肉注射妥布霉素。
90例患者（29.7%）完全没有不良反应，136例（44.9%）报告至少有一项轻微并发症（血尿、血精或自限性排尿困难）。最后，77例（25.4%）出现严重并发症——尿潴留、发热、需要医疗协助（初级或医院护理）或治疗。35例患者（11.5%）报告活检后发热，145例（47.8%）血尿，95例（31.3%）血精，77例（25.4%）直肠出血，67例（22.1%）排尿困难，9例（2.9%）尿潴留。多达39例（12.8%）需要看全科医生，其中19例被转诊至医院，只有6例（1.9%）住院超过24小时。未报告有重症监护病房收治病例或死亡病例。
根据我们的经验，经直肠活检后不良反应发生率较高。这种现象部分可以通过自行填写问卷收集数据来解释。这里出现的高热率可能通过其他类型的抗生素预防措施而降低。
