Nakai Yasushi, Tanaka Nobumichi, Matsubara Toshihiko, Anai Satoshi, Miyake Makito, Hori Shunta, Fujii Tomomi, Ohbayashi Chiho, Fujimoto Kiyohide
Department of Urology, Nara Medical University, Nara, Japan.
Department of Diagnostic Pathology, Nara Medical University, Nara, Japan.
Res Rep Urol. 2021 Mar 4;13:111-120. doi: 10.2147/RRU.S297703. eCollection 2021.
To evaluate factors correlated with pain during prostate biopsy and willingness to undergo transrectal ultrasound-guided prostate biopsy (TR-PBx) again without anesthesia in patients undergoing TR-PBx without anesthesia.
This retrospective, single-center study evaluated 624 patients who underwent TR-PBx without anesthesia. Based on a nomogram using patient age and prostate volume, 6-12 core biopsy samples were allocated. Anxiety was evaluated using the Faces Anxiety Scale before the TR-PBx. Pain was evaluated using the Faces Pain Scale at each puncture and immediately after confirmation of cessation of bleeding from the rectum after the transrectal probe was pulled out. The question "If this operation must be repeated, would you agree to undergo it again under same conditions?" was asked after the procedure was completed. The change in pain at each puncture and factors correlated with post-procedural pain were calculated using multiple regression analysis, and factors predicting an answer of "yes" to the question using binary logistic analysis were evaluated.
Scores on the Faces Pain Scale significantly increased from the first core sample to last as the number of samples increased. However, the number of samples did not show significant correlation with pain evaluated after the procedure was complete. Time during the biopsy and the anxiety score had a significant correlation with the pain scale score for the completed procedure. Short duration of TR-biopsy and a low anxiety score predicted a reply of "Yes" to the question.
A long operative time during the TR-PBx procedure and strong pre-procedure anxiety can increase pain for patients undergoing the procedure without anesthesia and cause patients to be unwilling to undergo TR-PBx again without anesthesia.
评估在未接受麻醉的情况下进行经直肠超声引导下前列腺穿刺活检（TR-PBx）的患者中，与穿刺活检期间疼痛相关的因素，以及再次在无麻醉状态下接受经直肠超声引导下前列腺穿刺活检的意愿。
这项回顾性单中心研究评估了624例未接受麻醉而进行TR-PBx的患者。根据使用患者年龄和前列腺体积的列线图，分配6-12个核心活检样本。在TR-PBx之前，使用面部焦虑量表评估焦虑情况。在每次穿刺时以及拔出经直肠探头后确认直肠出血停止后，立即使用面部疼痛量表评估疼痛情况。在手术完成后，询问“如果必须重复此手术，您是否同意在相同条件下再次进行？”这一问题。使用多元回归分析计算每次穿刺时疼痛的变化以及与术后疼痛相关的因素，并使用二元逻辑分析评估对该问题回答“是”的预测因素。
随着样本数量的增加，面部疼痛量表的分数从第一个核心样本到最后一个核心样本显著增加。然而，样本数量与手术完成后评估的疼痛没有显著相关性。活检期间的时间和焦虑评分与完成手术的疼痛量表评分有显著相关性。TR活检时间短和焦虑评分低预测对该问题的回答为“是”。
TR-PBx手术期间手术时间长和术前焦虑强烈会增加未接受麻醉的患者的疼痛，并导致患者不愿意再次在无麻醉状态下接受TR-PBx。
