Khairul-Asri M G, Jaharudin M E A, Khor V Khor V, Yusof M R, Mohamad Sharin M F, Jagwani A Jagwani A, Lee F Y, Lee C S K, Fahmy O Fahmy O
Department of Urology, Hospital Sultan Abdul Aziz Shah, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia.
Department of Urology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysiaa.
Urologiia. 2024 Sep(4):87-93.
To compare the tolerability and feasibility of transrectal(TR) versus transperineal (TP) routes for prostate biopsy under local anaesthesia(LA). To assess the functional outcome and the complication of both procedures.
s. A prospective cohort observational study was performed on patients who underwent prostate biopsy under LA. Visual Analogue Scale (VAS) was used during the procedure. International Prostate Symptoms Score (IPSS) and International Index of Erectile dysfunction (IIEF) were assessed before the procedure and in 14 days after the procedure. Complication for each procedure was recorded.
A total of 128 patients with 64 patients for each group underwent prostate biopsy by TP and TR under LA. TP targeted biopsy group had comparable pain scores to those who underwent the procedure using the TR routes. The median pain score for the TP group was 2 and TR was 3, (IQR=2, range 0-10 for both groups)with no significant pain difference between both groups (P=0.48). Furthermore, there was no significant difference in urinary function(p=0.68) and sexual function (p=0.19) between the two groups post-procedure. Both groups have similar rates of complications, with no significant difference observed. Urinary tract infection incidents that did occur were rare and did not significantly differ between the groups (p=0.21). None of the patients experienced sepsis postoperatively. AUR was reported in both groups, slightly higher with 9.4%(N=6) in the TP group and 6.3%(N=4) in the TR group however no significant difference(p=0.112) was noted. Haematuria is common in both groups with TP (66%) and TR (59%) but self-limiting with Clavien-Dindo grade I without significant difference (p=0.589).
Our results showed that both Transperineal and transrectal approaches have similar tolerability with no significant difference in functional outcome or complications. Further studies are mandatory to verify our results.
比较经直肠（TR）与经会阴（TP）途径在局部麻醉（LA）下进行前列腺活检的耐受性和可行性。评估两种手术方式的功能结局和并发症。
对在局部麻醉下接受前列腺活检的患者进行前瞻性队列观察研究。手术过程中使用视觉模拟评分法（VAS）。在手术前和手术后14天评估国际前列腺症状评分（IPSS）和国际勃起功能障碍指数（IIEF）。记录每种手术的并发症。
共有128例患者，每组64例，分别在局部麻醉下通过经会阴和经直肠途径进行前列腺活检。经会阴靶向活检组的疼痛评分与经直肠途径手术的患者相当。经会阴组的中位疼痛评分为2分，经直肠组为3分（两组的四分位距均为2，范围为0 - 10），两组之间无显著疼痛差异（P = 0.48）。此外，两组术后的排尿功能（P = 0.68）和性功能（P = 0.19）无显著差异。两组的并发症发生率相似，未观察到显著差异。确实发生的尿路感染事件很少，两组之间无显著差异（P = 0.21）。术后没有患者发生败血症。两组均报告了急性尿潴留，经会阴组略高，为9.4%（N = 6），经直肠组为6.3%（N = 4），但无显著差异（P = 0.112）。血尿在两组中都很常见，经会阴组为66%，经直肠组为59%，但为Clavien - Dindo I级自限性，无显著差异（P = 0.589）。
我们的结果表明，经会阴和经直肠途径具有相似的耐受性，在功能结局或并发症方面无显著差异。需要进一步研究以验证我们的结果。
