Salar Remzi, Erbay Güven
Urology Clinic, Mehmet Akif Inan Training and Research Hospital, Sanliurfa, Turkey.
Urology Clinic, Karamanoglu Mehmetbey University Faculty of Medicine, Karaman, Turkey.
Urologia. 2022 Nov;89(4):541-546. doi: 10.1177/03915603211038344. Epub 2021 Dec 29.
To evaluate voiding dysfunction and morbidity after transrectal ultrasound (TRUS)-guided prostate biopsy and to investigate whether pre-intervention alpha-blocker treatment had any effect on morbidity and voiding dysfunction.
The study included 197 consecutive patients who underwent TRUS-guided prostate biopsy between January 2014 and January 2018. The patients were divided into two groups, those receiving alpha-blocker (silodosin) and those not receiving alpha-blocker treatment before the procedure (controls). All patients were evaluated before and one week after the procedure with the International Prostate Symptom Score (IPSS), measurements of maximum flow rate (), post-void residual urine volume (PVR) and prostate volume, and procedure-related complications were also recorded. All analyzed parameters were compared by within-group and between-group evaluations.
There was no significant difference between the two groups in terms of IPSS, and prostate volume values before biopsy. In the follow-up evaluation performed on the seventh day after biopsy, IPSS, PVR and prostate volume were found to be increased, whereas was decreased in the control group ( < 0.05). In the silodosin group, an increase in prostate volume was observed, but there were no significant changes in IPSS, and PVR values. Acute urinary retention (AUR) after the biopsy procedure developed in two patients (2%) in the silodosin group, and in nine patients (9.1%) in the control group ( = 0.02). No significant difference was found between the two groups in terms of biopsy-related complications, except for AUR.
We believe that alpha-blocker treatment initiated before biopsy may be advantageous in preventing voiding dysfunction that may develop after the procedure.
评估经直肠超声(TRUS)引导下前列腺穿刺活检后的排尿功能障碍及发病率,并研究干预前使用α受体阻滞剂治疗是否对发病率及排尿功能障碍有任何影响。
本研究纳入了2014年1月至2018年1月期间连续接受TRUS引导下前列腺穿刺活检的197例患者。患者被分为两组,一组在穿刺前接受α受体阻滞剂(西洛多辛)治疗,另一组未接受α受体阻滞剂治疗(对照组)。所有患者在穿刺前及穿刺后1周均采用国际前列腺症状评分(IPSS)、最大尿流率()、残余尿量(PVR)及前列腺体积进行评估,并记录与穿刺相关的并发症。所有分析参数均通过组内和组间评估进行比较。
两组在穿刺活检前的IPSS、及前列腺体积值方面无显著差异。在穿刺活检后第7天进行的随访评估中,对照组的IPSS、PVR及前列腺体积增加,而降低(<0.05)。在西洛多辛组中,观察到前列腺体积增加,但IPSS、及PVR值无显著变化。西洛多辛组有2例患者(2%)在穿刺活检后发生急性尿潴留(AUR),对照组有9例患者(9.1%)发生急性尿潴留(=0.02)。除AUR外,两组在与穿刺活检相关并发症方面无显著差异。
我们认为,穿刺活检前开始使用α受体阻滞剂治疗可能有利于预防穿刺后可能发生的排尿功能障碍。