Morbidity with Contemporary Prostate Biopsy

Desmond, Patricia; Clark, Joseph Y.; Thompson, Ian M.; Zeidman, Eric J.; Mueller, Edward J.

doi:10.1016/s0022-5347(17)35798-1

Cited by 81 publications

(31 citation statements)

References 10 publications

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“…There was no signi®cant added infection risk, while the incidence of haematuria, haematochezia and haematospermia was also similar and compared favourably with previous studies [4,10,11]. There has been concern that the administration of periprostatic LA may result in ®brosis and interfere with nerve-sparing radical prostatectomy [12]; this has not been our experience (personal communication, Mr R. Kirby), but further data are required.…”

Section: Discussionsupporting

confidence: 61%

“…In our department, patient surveys [9] have shown that up to 30% of men report pain of any severity, and procedural pain is recognized as a signi®cant limitation to increasing the number of biopsies taken to minimize sampling error [10]. Pain also discourages those patients with high-grade PIN or persistent clinical suspicion of unidenti®ed prostate cancer from agreeing to repeat biopsies.…”

Section: Discussionmentioning

confidence: 99%

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Pain after transrectal ultrasonography‐guided prostate biopsy: the advantages of periprostatic local anaesthesia

Seymour¹,

Perry²,

Lee-Elliot³

et al. 2001

BJU International

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Objective To prospectively evaluate the ef®cacy and safety of periprostatic local anaesthesia (LA) during prostatic biopsy guided by transrectal ultrasonography (TRUS), as 20±65% of men report moderate to severe pain, and there is anecdotal and published evidence that periprostatic anaesthesia improves patients' tolerance. Patients and methods In all, 157 patients were prospectively recruited and sequentially randomized to receive either LA or no anaesthesia. Sextant biopsies were taken in all men but some had more than six biopsies. All were asked to complete questionnaires immediately after TRUS-guided biopsy and for the subsequent week, giving pain scores and recording any morbidity, including symptoms of infection; analgesic use was also surveyed. Results Patients given LA had signi®cantly lower pain scores at the time of biopsy than those given no anaesthesia, with median (SD) pain scores of 1.53 (0.7) and 1.95 (0.65) (P<0.001), respectively. In addition, there was a trend towards less analgesic use by those given LA, although this was not statistically signi®cant. There was no difference in the amount of haematuria, haematochezia or haematospermia, or infection rate, between the groups. The additional cost and time of the procedure was minimal (£3.00 and 3 min/per patient, respectively). Conclusion Periprostatic LA in®ltration is a quick and simple procedure which signi®cantly improves immediate pain with no added morbidity; we strongly advocate its use to improve patient tolerance of TRUS-guided prostate biopsy.

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Section: Discussionsupporting

confidence: 61%

Section: Discussionmentioning

confidence: 99%

Pain after transrectal ultrasonography‐guided prostate biopsy: the advantages of periprostatic local anaesthesia

Seymour¹,

Perry²,

Lee-Elliot³

et al. 2001

BJU International

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“…[6][7][8][9] A review of recent MEDLINE English literature studies that report on complications of transrectal prostate biopsies and list hematochezia as a complication, showed that of 5911 men biopsied only four required admission for observation of hematochezia, three had oversewing of the rectal mucosa within 2 h of the biopsy to stop bleeding and none required transfusion (Table 1). [10][11][12][13][14][15][16][17] This man had an arterial bleeder that opened 5 days after his biopsy; poorly controlled hypertension and the firm bowel movement most likely contributed to the life-threatening hemorrhage. Neovascularization related to his large volume of disease with high Gleason-grade carcinoma may also have contributed to this patient's excessive bleeding.…”

Section: Discussionmentioning

confidence: 99%

Delayed life-threatening hemorrhage after transrectal prostate needle biopsy

Petroski

Griewe

Schenkman

2003

Prostate Cancer Prostatic Dis

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“…The test itself is uncomfortable, but it has become much more tolerable with the application of local anesthetic [39]. The primary risks of the procedure are infection and bleeding, which fortunately occur in only 1 Á/4% of cases [40]. The more important issues concern the potential morbidity associated with treatment.…”

Section: Surgery and Radiation For Prostate Cancer (The Treatment)mentioning

confidence: 99%

Is screening for prostate cancer with prostate specific antigen an appropriate public health measure?

Albertsen

2005

Acta Oncologica

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Screening and treatment for prostate cancer is controversial. In the absence of randomized trials, several prominent medical organizations in the United States and Europe have formulated policies that range from enthusiastic support to significant skepticism concerning the efficacy of screening and subsequent treatment for prostate cancer. Sharp rises in the incidence of prostate cancer have occurred whenever PSA testing has been introduced on a wide scale. Unfortunately, it is unclear whether declines in prostate cancer mortality can be attributed to PSA testing. Other explanations include the early use of anti-androgen therapy or changes in environmental factors such as diet. Repeated testing for serum PSA has produced significant shifts in the types of cases being identified and has raised the possibility of significant over-diagnosis of this disease. The European screening trial and the PLCO trial in the US will hopefully provide some insights into the value of population-based testing.

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Morbidity with Contemporary Prostate Biopsy

Cited by 81 publications

References 10 publications

Pain after transrectal ultrasonography‐guided prostate biopsy: the advantages of periprostatic local anaesthesia

Pain after transrectal ultrasonography‐guided prostate biopsy: the advantages of periprostatic local anaesthesia

Delayed life-threatening hemorrhage after transrectal prostate needle biopsy

Is screening for prostate cancer with prostate specific antigen an appropriate public health measure?

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