Michigan Medicine, Department of Radiology, Ann Arbor, Michigan.
Michigan Medicine, Michigan Radiology Quality Collaborative, Ann Arbor, Michigan.
J Urol. 2021 Dec;206(6):1403-1410. doi: 10.1097/JU.0000000000002118. Epub 2021 Jul 21.
We sought to assess the temporary health-related quality of life (health utility) of nonmagnetic resonance imaging-guided transrectal and transperineal prostate biopsy.
This is a 2-arm, prospectively enrolled, observational, patient-reported outcomes study, performed between June 2019 and November 2020 at a single academic medical center. Inclusion criteria were men undergoing an outpatient ultrasound-guided prostate biopsy (transrectal or transperineal approach, without magnetic resonance imaging guidance). Patients with a history of Gleason 7+ prostate cancer were excluded. Validated survey instruments were utilized to assess baseline (Short Form 12) and testing-related (Testing Morbidities Index [TMI]) health utility states. The primary outcome was the TMI summary testing-related quality-of-life score (summary utility score; scale: 0=death and 1=perfect health). The TMI is comprised of 7 domains, spanning before, during and after testing experiences. Each domain is scored from 1 (no health impact) to 5 (extreme health impact). Testing-related quality-of-life measures were compared with Mann-Whitney U test.
Enrollment rates were 80% (60/75; transrectal) and 86% (60/70; transperineal). All patients (120/120) completed the questionnaire. The TMI summary score for transrectal biopsy was not significantly different from transperineal biopsy (0.86, 95% CI 0.84-0.88 vs 0.83, 95% CI 0.81-0.85; p=0.0774). The largest difference in the testing experiences was related to intraprocedural pain (transrectal biopsy: 2.3, 95% CI 2.1-2.4; transperineal biopsy: 2.9, 95% CI 2.6-3.1; p <0.001).
Transperineal and transrectal prostate biopsies have similar effect on temporary health-related quality-of-life. Transient differences relate to intraprocedural pain. These data can inform clinical decision making and future cost-utility models.
我们旨在评估非磁共振成像引导经直肠和经会阴前列腺活检的临时健康相关生活质量（健康效用）。
这是一项 2 臂、前瞻性纳入、观察性、患者报告结局研究，于 2019 年 6 月至 2020 年 11 月在一家学术医疗中心进行。纳入标准为接受门诊超声引导前列腺活检的男性（经直肠或经会阴入路，无磁共振成像引导）。排除有前列腺癌 Gleason 7+病史的患者。使用经过验证的调查工具评估基线（简短 12 项健康调查量表）和与检测相关的（检测不良事件指数）健康效用状态。主要结局是 TMI 综合检测相关生活质量评分（综合效用评分；范围：0=死亡和 1=完美健康）。TMI 由 7 个领域组成，涵盖检测前、检测中和检测后的体验。每个领域的评分为 1（无健康影响）至 5（极度健康影响）。采用 Mann-Whitney U 检验比较与检测相关的生活质量测量结果。
入组率分别为 80%（60/75；经直肠）和 86%（60/70；经会阴）。所有患者（120/120）均完成了问卷调查。经直肠活检的 TMI 综合评分与经会阴活检无显著差异（0.86，95%CI 0.84-0.88 比 0.83，95%CI 0.81-0.85；p=0.0774）。检测体验中最大的差异与术中疼痛相关（经直肠活检：2.3，95%CI 2.1-2.4；经会阴活检：2.9，95%CI 2.6-3.1；p<0.001）。
经会阴和经直肠前列腺活检对临时健康相关生活质量的影响相似。短暂的差异与术中疼痛有关。这些数据可以为临床决策和未来的成本效用模型提供信息。
