Coşkun Çağrı, Cem Bulut Ender, Çetin Serhat, Aydın Uğur, Küpeli Bora
Department of Urology, Ağrı Training and Research Hospital, Ağrı, Turkey.
Department of Urology, School of Medicine, Gazi University, Ankara, Turkey.
Scand J Urol. 2025 Feb 19;60:43-49. doi: 10.2340/sju.v60.43106.
Combined biopsy (CBx) is a combination of multiparametric magnetic resonance imaging (MpMRI)-targeted prostate biopsy (FBx) and systematic biopsy (SBx). CBx offers highly accurate diagnostic rates, but the increased number of cores taken and the longer procedure time may pose challenges in tolerability compared to traditional biopsies in terms of pain and anxiety. This situation leads to the need to evaluate pain and anxiety.
In a tertiary hospital in Turkey, 149 patients with suspicious lesions (PI-RADS ≥ 3 on MpMRI) who underwent transrectal CBx were included between May 2023 and August 2023. Following FBx, patients underwent a 12-core systematic biopsy. During CBx, 78 patients listened to classical music, while 71 patients used noise-canceling headphones without music. Ten minutes after the procedure, patients completed the Visual Analog Scale (VAS) and the State-Trait Anxiety Inventory (s-STAI, t-STAI) questionnaires to measure pain and anxiety. s-STAI determines how anxious a person feels at a specific moment. t-STAI indicates the general level of anxiety a person experiences independently of their current situation.
Median VAS score was 3.6 (3.0 - 4.3) in the music group and 5.4 (4.4 - 6.9) in the control group (p < 0.001). The median s-STAI score was 38 (34 - 44) in the music group and 44 (39 - 48) in the control group (p < 0.001). For t-STAI scores, no significant difference between groups was observed. Conclusion: Incorporating music during CBx, alongside traditional pain management, effectively reduces pain and anxiety levels. Its cost-effectiveness, accessibility, and non-invasive nature make routine use of music during CBx procedures advantageous for pain palliation.
联合活检（CBx）是多参数磁共振成像（MpMRI）靶向前列腺活检（FBx）和系统活检（SBx）的结合。CBx具有高度准确的诊断率，但与传统活检相比，所取活检组织芯数量增加以及操作时间延长，在疼痛和焦虑方面的耐受性可能会带来挑战。这种情况导致需要评估疼痛和焦虑。
在土耳其的一家三级医院，纳入了2023年5月至2023年8月期间接受经直肠CBx的149例可疑病变患者（MpMRI上PI-RADS≥3）。在FBx之后，患者接受了12芯系统活检。在CBx过程中，78例患者听古典音乐，而71例患者使用无音乐的降噪耳机。操作后10分钟，患者完成视觉模拟量表（VAS）和状态-特质焦虑量表（s-STAI、t-STAI）问卷以测量疼痛和焦虑。s-STAI确定一个人在特定时刻的焦虑程度。t-STAI表明一个人独立于其当前状况所经历的总体焦虑水平。
音乐组的VAS评分中位数为3.6（3.0 - 4.3），对照组为5.4（4.4 - 6.9）（p < 0.001）。音乐组的s-STAI评分中位数为38（34 - 44），对照组为44（39 - 48）（p < 0.001）。对于t-STAI评分，两组之间未观察到显著差异。结论：在CBx过程中加入音乐，与传统疼痛管理方法一起，可有效降低疼痛和焦虑水平。其成本效益、可及性和非侵入性使得在CBx操作过程中常规使用音乐对缓解疼痛具有优势。
