Lee George, Attar Kakahama, Laniado Marc, Karim Omer
Department of Urology, Wexham Park Hospital, 8 Marloes Road, W8 5LJ, Slough, Berks, UK.
Int Urol Nephrol. 2006;38(2):281-5. doi: 10.1007/s11255-006-6671-6.
We prospectively evaluate the safety, morbidity and characteristics of complications for transrectal ultrasound guided needle biopsy of prostate carried out solely by urologists in a single unit. This will help to counsel patient prior to the biopsy.
One hundred consecutive patients were recruited to complete questionnaires prospectively, 2 weeks and 3 months after TRUS and prostate biopsy. Haematospermia, haematuria and rectal bleeding characteristics were evaluated. Pain, analgesia requirement, infection and urinary retention rates were also assessed.
Ninety-two patients (92%) returned questionnaires 2 weeks and 63 patients (63%) three months after the biopsy. At 2 weeks questionnaire, 58 patients (63%) experienced haematuria and 9 patients (10%) for more than 1 week. Eighty-five percent of the 58 patients who had haematuria described it as mild and intermittent. Twenty-three (25%) patients experienced a rectal bleed and none for more than four days. Only 1 patient experienced clots with the rectal bleeding. Twelve (13%) patients had difficulty passing urine but the symptoms resolved by day four. Acute urinary retention did not occur. Thirty-five (38%) patients had some degree of discomfort and only one patient had pain for more than three days. Twenty-five (27%) patients took analgesia between 1 and 8 days (Mean 3 days). Two patients had a urinary tract infection despite prophylactic antibiotics. At three months, 4 patients (6%) had experienced secondary haematuria 3 weeks after the biopsy. Two patients experienced more rectal bleeding 2 weeks after the biopsy and 1 patient had residual discomfort 2 weeks after the procedure. Thirteen patients (21%) had haematospermia between day 6 and 56 (Mean 21 days).
Transrectal ultrasound guided biopsy of the prostate is generally well tolerated with minor pain and morbidity in our urologist-led service. Our data will assist counselling of patients prior to the procedure.
我们前瞻性地评估了在单一科室仅由泌尿科医生进行的经直肠超声引导下前列腺穿刺活检的安全性、并发症发生率及并发症特征。这将有助于在活检前为患者提供咨询。
连续招募100例患者，在经直肠超声（TRUS）及前列腺活检后2周和3个月前瞻性地完成问卷调查。评估血精、血尿及直肠出血特征。还评估了疼痛、镇痛需求、感染及尿潴留发生率。
92例患者（92%）在活检后2周返回问卷，63例患者（63%）在3个月后返回问卷。在2周问卷中，58例患者（63%）出现血尿，其中9例（10%）血尿持续超过1周。58例血尿患者中85%称症状轻微。23例（25%）患者出现直肠出血，无一例超过4天。仅有1例患者直肠出血伴有血凝块。12例（13%）患者排尿困难，但症状在第4天缓解。未发生急性尿潴留。35例（38%）患者有一定程度的不适，仅1例患者疼痛超过3天。25例（27%）患者在1至8天内服用镇痛药（平均3天）。尽管使用了预防性抗生素，仍有2例患者发生尿路感染。在3个月时，4例患者（6%）在活检后3周出现继发性血尿。2例患者在活检后2周出现更多直肠出血，1例患者在术后2周仍有残余不适。13例患者（21%）在第6至56天（平均21天）出现血精。
在我们由泌尿科医生主导的服务中，经直肠超声引导下前列腺活检一般耐受性良好，疼痛和并发症发生率较低。我们的数据将有助于在术前为患者提供咨询。
