Morgan Eileen, Drummond Frances J, Coyle Catherine, Sharp Linda, Gavin Anna T
Northern Ireland Cancer Registry, Centre for Public Health, Belfast, Northern Ireland.
Department of Epidemiology and Public Health, University College Cork, Cork, Republic of Ireland.
Urol Oncol. 2017 Oct;35(10):604.e11-604.e16. doi: 10.1016/j.urolonc.2017.06.003. Epub 2017 Jul 10.
As the incidence of prostate cancer has, until recently, increased in most developed countries, the rates of prostate biopsies, required for histological diagnosis, will also have increased. Little is known about the physical after-effects of prostate biopsy outside randomised control trials. We investigate reports on the physical effect of prostate biopsy undertaken in men in routine practice.
A self-completed questionnaire was given to men living in the Republic of Ireland (RoI) or Northern Ireland 4 to 6 weeks after prostate biopsy. Men were asked about whether they experienced specific physical after-effects postbiopsy (raised temperature/pain/bleeding/erectile dysfunction/urinary retention) and, if so, their severity and duration, and any associated health care uses. Binomial and ordinal logistic regression was used to investigate factors associated with postbiopsy after-effects (presence/absence) and number of after-effects reported, respectively.
Postbiopsy after-effects were common with 88.1% of 335 respondents reporting at least 1 after-effect; 21% reported at least 3. The odds of increasing number of after-effects was over 2-fold in men with both intermediate (odds ratio [OR] = 2.59, 95% CI: 1.52-4.42) and high (OR = 2.52, 95% CI: 1.28-4.94) levels of health anxiety and for men who had had multiple previous biopsies (adjusted OR = 2.02, 95% CI: 1.20-3.41). A total of 21.3% of men who experienced after-effects reported that they were worse than expected, 11.5% with after-effects reported contacting their doctor or local pharmacy, 14.6% contacted hospital services, and 3.1% of men with after-effects were admitted to hospital with an average stay of 5.4 nights (standard deviation = 6.3).
Physical after-effects following prostate biopsy in routine practice are common, and in some men, serious enough to warrant contacting hospital or community services. Men with increased health anxiety or who undergo multiple biopsies might benefit from additional support.
直到最近，大多数发达国家前列腺癌的发病率一直在上升，因此组织学诊断所需的前列腺活检率也会相应增加。在随机对照试验之外，人们对前列腺活检的身体后遗症知之甚少。我们调查了常规医疗中男性前列腺活检身体影响的报告。
在前列腺活检4至6周后，向居住在爱尔兰共和国（RoI）或北爱尔兰的男性发放一份自我填写的问卷。询问男性活检后是否经历过特定的身体后遗症（体温升高/疼痛/出血/勃起功能障碍/尿潴留），如果有，后遗症的严重程度和持续时间，以及任何相关的医疗保健使用情况。分别使用二项式和有序逻辑回归来研究与活检后后遗症（存在/不存在）和报告的后遗症数量相关的因素。
活检后后遗症很常见，335名受访者中有88.1%报告至少有一种后遗症；21%报告至少有三种。健康焦虑程度处于中等（比值比[OR]=2.59，95%置信区间：1.52-4.42）和高（OR=2.52，95%置信区间：1.28-4.94）水平的男性以及之前接受过多次活检的男性，后遗症数量增加的几率超过2倍（调整后的OR=2.02，95%置信区间：1.20-3.41）。经历过后遗症的男性中，共有21.3%报告后遗症比预期严重，11.5%报告联系过医生或当地药房，14.6%联系过医院服务，3.1%有后遗症的男性因后遗症住院，平均住院5.4晚（标准差=6.3）。
常规医疗中前列腺活检后的身体后遗症很常见，在一些男性中，严重程度足以需要联系医院或社区服务。健康焦虑增加或接受多次活检的男性可能会从额外的支持中受益。
