侯鎮邦, 張慧朗, 陳建綸, 林友翔, 周智原, 崔克宏
Identifying the Variables Associated With Pain during Transrectal Ultrasonography of the Prostate
Chen-Pang Hou, MD; Phei-Lang Chang, MD; Chien-Lun Chen, MD,PhD; Yu-Hsiang Lin, MD; Chou Chih-Yuan, Ke-Hung Tsui, MD.
Department of Urology, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Purpose: The purpose of this study was to prospectively investigate the degree of pain experienced by patients receiving transrectal ultrasonography (TRUS) of the prostate by applying a visual analogue scale (VAS). We also identified the clinical parameters influencing pain during the TRUS examination.
Materials and Methods: Records were obtained from a prospective database for male patients who received TRUS of prostate in the outpatient department of Chang-Gung Memorial Hospital, Taiwan, from January 2014 to June 2014. The patients underwent a detailed physical examination and medical history review. Immediately after the TRUS examination, the patients completed questionnaires based on a 10-point visual analogue pain scale. The variables of interest were age, body mass index, prostate volume, prostate sagittal length, prostatic specific antigen, previous TRUS experience, external hemorrhoids, anal surgical history, prostate calcification, and image artifact caused by stool in the rectum. All variables were correlated to the VAS by applying multivariate regression analysis.
Results: By using linear regression analysis, we identified the independent factors that affected the pain score during the TRUS examination. The patients who received the examination for the first time or had longer prostate sagittal lengths, external hemorrhoids, anal surgical history, or stool stored in the rectum all experienced more pain during the TRUS examination. Furthermore, the pain was reduced when we provided the patients with a detailed explanation before the procedure and allowed them to observe the real-time image during the examination
Although a TRUS examination is uncomfortable for patients, after having identified the factors affecting pain, physicians can assist patients in reducing pain during the procedure, thus providing higher quality examinations.