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Wadhwa K, Carmona-Echeveria L, Kuru T, Gaziev G, Serrao E, Parashar D, Frey J, Dimov I, Seidenader J, Acher P, Muir G, Doble A, Gnanapragasam V, Hadaschik B, Kastner C. Transperineal prostate biopsies for diagnosis of prostate cancer are well tolerated: a prospective study using patient-reported outcome measures. Asian J Androl 2017; 19:62-66. [PMID: 26924279 PMCID: PMC5227677 DOI: 10.4103/1008-682x.173453] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
We aimed to determine short-term patient-reported outcomes in men having general anesthetic transperineal (TP) prostate biopsies. A prospective cohort study was performed in men having a diagnostic TP biopsy. This was done using a validated and adapted questionnaire immediately post-biopsy and at follow-up of between 7 and 14 days across three tertiary referral hospitals with a response rate of 51.6%. Immediately after biopsy 43/201 (21.4%) of men felt light-headed, syncopal, or suffered syncope. Fifty-three percent of men felt discomfort after biopsy (with 95% scoring <5 in a 0-10 scale). Twelve out of 196 men (6.1%) felt pain immediately after the procedure. Despite a high incidence of symptoms (e.g., up to 75% had some hematuria, 47% suffered some pain), it was not a moderate or serious problem for most, apart from hemoejaculate which 31 men suffered. Eleven men needed catheterization (5.5%). There were no inpatient admissions due to complications (hematuria, sepsis). On repeat questioning at a later time point, only 25/199 (12.6%) of men said repeat biopsy would be a significant problem despite a significant and marked reduction in erectile function after the procedure. From this study, we conclude that TP biopsy is well tolerated with similar side effect profiles and attitudes of men to repeat biopsy to men having TRUS biopsies. These data allow informed counseling of men prior to TP biopsy and a benchmark for tolerability with local anesthetic TP biopsies being developed for clinical use.
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Affiliation(s)
- Karan Wadhwa
- Department of Urology, Addenbrookes Hospital, Cambridge, UK
| | | | - Timur Kuru
- Department of Urology, University Hospital Heidelberg, Germany
| | | | - Eva Serrao
- Department of Biochemistry, University of Cambridge, Cambridge, UK
| | - Deepak Parashar
- Cancer Research Centre and Statistics and Epidemiology Unit, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Julia Frey
- Department of Urology, Addenbrookes Hospital, Cambridge, UK
| | - Ivailo Dimov
- Department of Urology, University Hospital Heidelberg, Germany
| | | | - Pete Acher
- Department of Urology, Southend University Hospital, Southend, UK
| | - Gordon Muir
- Department of Urology, Kings College Hospital, London, UK
| | - Andrew Doble
- Department of Urology, Addenbrookes Hospital, Cambridge, UK.,CamPARI Prostate Cancer Clinic, Addenbrookes Hospital, Cambridge UK
| | - Vincent Gnanapragasam
- Department of Urology, Addenbrookes Hospital, Cambridge, UK.,CamPARI Prostate Cancer Clinic, Addenbrookes Hospital, Cambridge UK
| | - Boris Hadaschik
- Department of Urology, University Hospital Heidelberg, Germany
| | - Christof Kastner
- Department of Urology, Addenbrookes Hospital, Cambridge, UK.,CamPARI Prostate Cancer Clinic, Addenbrookes Hospital, Cambridge UK
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