Shen B-Y, Chang P-L, Lee S-H, Chen C-L, Tsui K-H
Division of Geriatric Urology, Department of Surgery, Chang Gung Memorial Hospital, Chang Gung University, Chang Gung Institute of Technology, Taoyuan, Taiwan, Republic of China.
Arch Androl. 2006 Mar-Apr;52(2):123-7. doi: 10.1080/01485010500316014.
In order to evaluate safety and morbidity aspects of additional systematic prostate biopsies, we have conducted a retrospective review of patients who had undergone transurethral resection of the prostate (TUR-P) combined with additional systemic prostate needle biopsies at the Chang Gung Memorial Hospital. To this end, the records of 80 men presenting consecutively at our institution between February 2001 and January 2004 inclusively were examined. These 80 individuals included patients experiencing obstructive voiding symptoms and those featuring suspicious screening parameters, all of whom were to undergo transurethral resection of the prostate for symptomatic benign prostatic hyperplasia (BPH), all procedures being performed by a single surgeon. A total of 20 (25%) specimens were found to be positive for prostate cancer. Cancer was detected in the transrectal prostate biopsy specimen of 16 of 57 men (28%) who had not undergone a previous prostate biopsy, and for four of 23 (17%) who had undergone at least one previous (benign) biopsy. Mild complications associated with transurethral prostrate resection, such as hematuria and hemospermia, were reported frequently, featuring rates of 10% and 2.5%, respectively; more severe complications being noted far less frequently. Fever, usually of a low grade, was observed post-operatively for six (7.5%) patients, but a prompt return to normal temperature following antibiotic treatment for one day was revealed. Four (5%) patients remained admitted to the hospital for a prolonged period following surgery. A review of the literature concerning transrectal biopsies and TUR-P has shown that surgery-associated complication rates are slightly lower than was the case for our study. Additional systematic prostate biopsies for patients undergoing TUR-P would appear to be a relatively safe treatment procedure. Identification of risk factors for post-surgery complications might further improve the safety of the screening procedure.
为了评估额外系统性前列腺活检的安全性和发病率情况，我们对在长庚纪念医院接受经尿道前列腺切除术（TUR-P）并同时进行额外系统性前列腺穿刺活检的患者进行了一项回顾性研究。为此，我们检查了2001年2月至2004年1月期间连续在我院就诊的80名男性患者的记录。这80名患者包括有排尿梗阻症状的患者以及筛查参数可疑的患者，他们均因有症状的良性前列腺增生（BPH）而准备接受经尿道前列腺切除术，所有手术均由同一位外科医生进行。总共发现20例（25%）标本前列腺癌呈阳性。在57名未曾接受过前列腺活检的男性中，有16名（28%）经直肠前列腺活检标本检测出癌症；在23名至少接受过一次（良性）活检的男性中，有4名（17%）检测出癌症。与经尿道前列腺切除术相关的轻度并发症，如血尿和血精，报告频率较高，发生率分别为10%和2.5%；更严重的并发症则较少见。术后有6名（7.5%）患者出现低热，但抗生素治疗一天后体温迅速恢复正常。4名（5%）患者术后住院时间延长。对有关经直肠活检和TUR-P的文献综述表明，手术相关并发症发生率略低于我们的研究。对于接受TUR-P的患者进行额外系统性前列腺活检似乎是一种相对安全的治疗方法。识别术后并发症的风险因素可能会进一步提高筛查程序的安全性。
