Park Ji Woon, Kim Jung Im, Bae Sang Rak, Lee Yong Seok, Han Chang Hee, Kang Sung Hak, Park Bong Hee
Department of Urology, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea.
Department of Radiology, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, Republic of Korea.
Medicine (Baltimore). 2019 May;98(20):e15623. doi: 10.1097/MD.0000000000015623.
To investigate the usefulness of the oxidized regenerated cellulose patch (ORCP) for postbiopsy hemostasis, anxiety, and depression in patients undergoing transrectal ultrasound-guided prostate biopsy.This was a prospective-retrospective study of 300 patients who underwent systematic 12-core prostate biopsy from August 2016 through March 2018. The ORCP was inserted into the rectum immediately after prostate biopsy in the prospective group (n = 150), while the retrospective group (n = 150) underwent prostate biopsy alone. The frequency rate and duration of hematuria, rectal bleeding, and hematospermia were compared between the 2 groups. Anxiety and depression were assessed with the hospital anxiety and depression scale before and after prostate biopsy in the prospective group.The frequency rates of hematuria and hematospermia showed no significant differences between the prospective versus retrospective groups (64.7% vs 66.7%, P = .881; 18 vs 20%, P = .718; respectively). Frequency of rectal bleeding was significantly lower in the prospective group than in the retrospective group (26.7% vs 42.7%, P = .018). However, there were no significant differences in median duration of rectal bleeding, hematuria, or hematospermia between the 2 groups (2, 5, and 2 days vs 2, 7, and 1 day, P > .05, respectively, for the prospective vs retrospective group). Multivariate analysis found that ORCP insertion was a significant protective factor against postbiopsy rectal bleeding (P = .038, odds ratio 0.52). Only anxiety level in the prospective group before versus after prostate biopsy was significantly reduced (5 vs 4, P = .011).ORCP insertion after prostate biopsy is an effective and simple method for decreasing rectal bleeding. ORCP insertion may also alleviate anxiety in patients undergoing prostate biopsy.
为研究氧化再生纤维素贴片（ORCP）在经直肠超声引导下前列腺穿刺活检患者中用于活检后止血、焦虑和抑郁的有效性。这是一项对2016年8月至2018年3月期间接受系统性12针前列腺穿刺活检的300例患者进行的前瞻性-回顾性研究。在前瞻性组（n = 150）中，前列腺穿刺活检后立即将ORCP插入直肠，而后瞻性组（n = 150）仅接受前列腺穿刺活检。比较两组血尿、直肠出血和血精的发生率及持续时间。在前瞻性组中，在前列腺穿刺活检前后用医院焦虑和抑郁量表评估焦虑和抑郁情况。血尿和血精的发生率在前瞻性组与回顾性组之间无显著差异（分别为64.7%对66.7%，P = 0.881；18%对20%，P = 0.718）。前瞻性组直肠出血的发生率显著低于回顾性组（26.7%对42.7%，P = 0.018）。然而，两组直肠出血、血尿或血精的中位持续时间无显著差异（前瞻性组与回顾性组分别为2天、5天和2天对2天、7天和1天，P均＞0.05）。多因素分析发现，插入ORCP是活检后直肠出血的显著保护因素（P = 0.038，比值比0.52）。仅前瞻性组前列腺穿刺活检前后的焦虑水平显著降低（5分对4分，P = 0.011）。前列腺穿刺活检后插入ORCP是减少直肠出血的有效且简单的方法。插入ORCP还可能减轻前列腺穿刺活检患者的焦虑。
