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与超声引导下前列腺活检患者疼痛感知相关的因素。

Factors associated with pain sensation in patients with ultrasound-guided prostate biopsy.

机构信息

University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, Urology Department, Istanbul. Turkey.

出版信息

Colomb Med (Cali). 2024 Mar 30;55(1):e2045781. doi: 10.25100/cm.v55i1.5781. eCollection 2024 Jan-Mar.

Abstract

INTRODUCTION

TRUS-guided prostate biopsy is a current method used to obtain the histopathological material necessary to make a definitive diagnosis of prostate cancer.

OBJECTIVE

To investigate patient-related variables affecting the level of pain felt during prostate biopsy to determine what can be done to minimize pain.

METHODS

The study included 241 patients scheduled for prostate biopsy. Four patients who did not meet the criteria were excluded. Local anesthesia was administered intrarectally 10 minutes before the biopsy to 237 patients, and a conventional 12-core biopsy was performed. The level of pain felt by all patients during the biopsy was measured using the Visual Analog Scale (VAS) score. Pain scores were compared by forming groups according to the selected parameters.

RESULTS

The mean age of the 237 included patients was 66.0±7.8 years, the mean serum PSA level was 33.7±197.5 ng/dL, and the mean prostate volume was 33.7±197.5 ml. The mean VAS score was 4.3±1.9. The pain score was higher in patients with positive digital rectal examination findings and lower in patients using 5-alpha reductase inhibitors(5-ARİ). At the same time, no significant difference was found in patients with positive tumor pathology, perineural invasion, alpha-blockers, or combination therapy.

CONCLUSION

Some patient parameters may affect the level of pain felt during TRUS-guided prostate biopsy.

摘要

简介

经直肠超声引导前列腺活检是目前获取前列腺癌组织病理学诊断所需的组织标本的方法。

目的

探讨影响前列腺穿刺活检疼痛程度的患者相关变量,以确定可以采取哪些措施来减轻疼痛。

方法

本研究纳入了 241 例计划进行前列腺活检的患者。其中 4 例不符合标准的患者被排除在外。237 例患者在活检前 10 分钟直肠内给予局部麻醉,并进行常规的 12 针前列腺活检。所有患者在活检过程中的疼痛程度均采用视觉模拟评分(VAS)进行测量。根据所选参数形成组,比较疼痛评分。

结果

237 例纳入患者的平均年龄为 66.0±7.8 岁,平均血清 PSA 水平为 33.7±197.5ng/dL,平均前列腺体积为 33.7±197.5ml。平均 VAS 评分为 4.3±1.9。直肠指检阳性的患者疼痛评分较高,使用 5-α还原酶抑制剂(5-ARI)的患者疼痛评分较低。同时,在肿瘤病理阳性、神经周围侵犯、α-受体阻滞剂或联合治疗的患者中,疼痛评分无显著差异。

结论

一些患者的参数可能会影响经直肠超声引导前列腺活检时的疼痛程度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f672/11523867/e8b61e3f81a2/1657-9534-cm-55-01-e2045781-gf1.jpg

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