Trends and risk factors for prostate biopsy complications in the pre-PSA and PSA eras, 1980 to 1997

Roberts, Rosebud O.; Bergstralh, Erik J.; Besse, Jennifer A.; Lieber, Michael M.; Jacobsen, Steven J.

doi:10.1016/s0090-4295(01)01465-0

Cited by 32 publications

(17 citation statements)

References 28 publications

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“…A review of the literature [2] shows that TRUS-guided prostate biopsy is associated with frequent minor (range 60-79%) and rare major (range 0.4-4.3%) complications. Hematospermia and hematuria have previously been reported as the two most common side effects of prostate biopsy [15].…”

Section: Resultsmentioning

confidence: 99%

“…Transrectal ultrasound (TRUS)-guided prostate biopsy is currently the mainstay of the diagnosis of prostate cancer [1]. The widespread use of prostate-specific antigen (PSA) and routine digital rectal examination for early prostate cancer detection have caused a dramatic increase in the number of prostate biopsies performed [2]. Although technical improvements in biopsy equipment and experience with the procedure may contribute to a decrease in the complication rate per biopsy, the overall increasing number of biopsies can be expected to result in an 4.1B1.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Relationship between Complications due to Prostate Biopsy and the Scores of Pain and Discomfort

Çelebi¹,

İrer²,

Kefi³

et al. 2004

Urol Int

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Introduction: Transrectal ultrasound (TRUS)-guided prostate biopsy is routinely performed in the prostate-specific antigen era. In this study, we evaluated morbidity and complications observed in patients undergoing TRUS-guided prostate biopsy following intrarectal lidocaine application and the relation of these complications to pain and discomfort. Patients and Methods: Between January 2000 and August 2002, a total of 128 patients underwent TRUS-guided prostate biopsy. The procedure was carried out following an intrarectal application of 10 cm³ 2% lidocaine gel. Immediately after the biopsy, pain and discomfort scores were determined using a 10-point linear visual analog scale. The patients were seen 10 days later and questioned for complications. Results: At least one complication was observed in 107 patients (84%). Most frequent complications were macroscopic hematuria (90%), hematochezia (36%), and hematospermia (13%). The mean pain and discomfort scores of the patients were found to be correlated to each other (p < 0.01). The complication-negative group had significantly lower pain and discomfort scores (p < 0.01). The scores of the patients with hematochezia were significantly higher than the scores of the patients with other complications (p < 0.01). Conclusions: Minor complications like hematuria, hematochezia, and hematospermia are frequently seen in patients undergoing TRUS-guided prostate biopsies. The pain and discomfort scores may be predictors of minor complications, particularly of rectal bleeding.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Relationship between Complications due to Prostate Biopsy and the Scores of Pain and Discomfort

Çelebi¹,

İrer²,

Kefi³

et al. 2004

Urol Int

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“…Doniesienia oparte na materiale minionych dwóch dekad wykazują też ujemne strony skriningu RS [31,32]. Carlsson, analizując badanie Goeteborg, wykazał, że w grupie chorych poddanych radykalnej prostatektomii, aby zapobiec 1 zgonowi z powodu raka, narażamy 1 chorego na nietrzymanie moczu, a 4 -na zaburzenia potencji [33]. Liczba powikłań związanych z niepotrzebną biopsją ulega zmniejszeniu z powodu lepszej prewencji i ograniczeniu liczby nieuzasadnionych biopsji [2,34].…”

Section: Metaanaliza Lumenaunclassified

Badania przesiewowe w kierunku wykrywania raka stercza. Aktualny stan wiedzy i argumenty za skriningiem

Stelmach¹,

Wohadło²

2013

Nowotwory. Journal of Oncology

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Screening for prostate cancer: current knowledge and arguments confi rming it's valueCentrum Onkologii -Instytut im. Marii Skłodowskiej-Curie, Oddział w Krakowie Wystąpienie podczas I Konferencji Naukowej czasopisma Nowotwory "Debaty onkologiczne" 5-6 kwietnia 2013 roku Poprawa ochrony zdrowia w ostatnich dekadach powoduje wydłużenie życia i starzenie się społeczeństwa, jednak pociąga za sobą rosnące koszty leczenia. Częstość oznaczania poziomu PSA wpływa na wzrost wskaźnika wykrywalności zachorowań na raka stercza (RS). Był on drugim co do częstości zachorowań i szóstą przyczyną zgonów z powodu nowotworów złośliwych na świecie w 2008 roku. Przed wprowadzeniem PSA dominowały rozpoznania zaawansowanych przypadków RS. W USA w 1988 roku RS miejscowo zaawansowanego (T3-4) rozpoznano u 55,5% badanych, zaś w 2005 tylko u 8,4%. W USA skrining PSA jest często stosowany, i w chwili rozpoznania stwierdza się tylko 4% rozsianych raków stercza. Omówione badania kliniczne i metaanalizy dostarczają argumentów zarówno za, jak i przeciw skriningowi. Podstawowy cel skriningu, czyli wzrost wykrywalności RS i spadek śmiertelności z tego powodu najczęściej został osiągnięty, jednak okupiony nadwykrywalnością, nadmiernym leczeniem oraz wzrostem powikłań i kosztów z tego powodu. Ocena indywidualnego ryzyka i nomogramy pozwalają na indywidualny skrining. AUA rekomenduje skrining u dobrze poinformowanych mężczyzn, rozpoczynający się po 40 rż. Zalecenia EAU na rok 2013 dotyczące skriningu w raku stercza rekomendują skrining powszechny u bezobjawowych mężczyzn w wieku 50-70 lat oraz skrining oportunistyczny, który obejmuje indywidualne postępowanie i jest inicjowany przez pacjenta i/lub lekarza. Punktami końcowymi obu typów skriningu jest redukcja śmiertelności z powodu raka stercza. Aktualnie wyzwanie dla skriningu RS to zmniejszenie nadwykrywalności i ograniczenie nadmiernego leczenia oraz wynikających z tego powikłań.

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“…6 The situation has recently been amplified by findings such as those from the prostate cancer prevention trial (PCPT), 12 indicating that historical cutoff levels for prostate cancer screening using a PSA level of 4 ng/mL may no longer be appropriate, particularly among younger men. Lastly, the decision to biopsy needs to be weighed against the complication rates of TRUS-BX, [13][14][15][16][17][18][19] particularly with more recent understanding of the frequency of serious infectious complications requiring hospitalization.…”

Section: Introductionmentioning

confidence: 99%

Variations in prostate biopsy practice: A quantitative questionnaire-based study

Lipinski

Groome

2013

CUAJ

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original research E732Cite as: Can Urol Assoc J 2013;7(11-12):e732-9. http://dx.doi.org/10.5489/cuaj.372 Published online November 8, 2013. AbstractBackground: The ambivalent results of recent large randomized prostate cancer studies have added a significant layer of uncertainty for clinicians and patients contemplating investigation of early disease. This uncertainty and lack of prescriptive recommendations from professional organizations has led to significant variation in practice in North America. The purpose of this study was to determine the extent of variation in biopsy recommendations by urologists and to discern factors predictive for these recommendations. Methods: An anonymous, cross-sectional, self-report questionnaire was sent to all active members of the Canadian Urological Association practicing in Ontario. The survey consisted of demographic data and 10 closed-ended questions designed to capture biopsy preferences in ambiguous clinical situations. Respondent preferences for recommending a prostate biopsy were compared to a guideline-informed study standard. Descriptive and correlative statistics were used to analyze the responses. Results: The response rate to the survey was 74%. The responses showed considerable variability in recommendations for or against biopsy. While most of the urologists concurred with the research team's study standard recommendations, only 4 scenarios had over 80% concurrence and 1 scenario, which centered on the utility of free PSA, had only had 42% concurrence. None of the respondent's descriptors were associated with trends to recommend biopsy other than the number of biopsies performed per year (p = 0.04). Interpretation: This self-report survey investigating prostate biopsy thresholds identifies considerable variation in practicing urologists in Ontario. The drivers of biopsy recommendations in these relatively ambiguous clinical situations appeared to be age, suspicious rectal examinations, and total PSA.

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Trends and risk factors for prostate biopsy complications in the pre-PSA and PSA eras, 1980 to 1997

Cited by 32 publications

References 28 publications

Relationship between Complications due to Prostate Biopsy and the Scores of Pain and Discomfort

Relationship between Complications due to Prostate Biopsy and the Scores of Pain and Discomfort

Badania przesiewowe w kierunku wykrywania raka stercza. Aktualny stan wiedzy i argumenty za skriningiem

Variations in prostate biopsy practice: A quantitative questionnaire-based study

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