尿滯留且攝護腺特定抗原升高病患施作
超音波導引攝護腺切片合併經尿道攝護腺刮除術
楊迪媛1,2、周永強1,2、林文榮1,2、柯明中3、陳建志1,2、張奐光1,2、
許炯明1,2、楊志東1,2、林文洲1,2、邱文祥1,2,4
1馬偕紀念醫院泌尿科, 2馬偕醫學院, 3臺北市立聯合醫院泌尿科, 4國立陽明大學醫學院
Concomitant transrectal ultrasound-guided biopsy and transurethral resection of prostate in patients with urinary retention and elevated prostate-specific antigen
Ti-Yuan Yang1,2, Yung-Chiong Chow1,2, Wun-Rong Lin1,2, Ming-Chung Ko3, Marcelo Chen1,2, Huang-Kuang Chang1,2, Jong-Ming Hsu1,2, Stone Yang1,2, Wen-Chou Lin1,2, Allen W. Chiu1,3,4
1Department of Urology, Mackay Memorial Hospital, Taipei, Taiwan, ROC
2Department of Medicine, Mackay Medical College, Taipei, Taiwan, ROC
3Taipei City Hospital, Taipei, Taiwan, ROC
4School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
Purpose: To determine whether concomitant transrectal ultrasound (TRUS)-guided biopsy and transurethral resection of prostate (TURP) is viable in patients with urinary retention and elevated prostate-specific antigen (PSA).
Materials and Methods: From March 2007 to May 2015, a total of 34 patients with urinary retention and elevated PSA (≥ 4 ng/ml) underwent concomitant TRUS-guided biopsy and TURP. The medical records were evaluated retrospectively, and data including PSA, prostate volume, TURP results, TRUS-guided biopsy results, length of hospitalization and complications were collected. These patients were then compared with 40 patients with urinary retention who underwent TURP alone.
Results: The mean age of the patients was 71.6 years. The mean PSA level was 16.9 ng/ml. Prostate cancer was detected in 8 cases (23.5%): one case by TRUS-guided biopsy alone, 2 by TURP alone, and 5 by both TRUS-guided biopsy and TURP. Complications included fever in 5 patients (14.7%), recatheterization for urine retention in 2 patients (5.9%) and de novo urge incontinence in 7 patients (20.6%). The complication rate was not significantly increased when compared with the patients who underwent TURP alone.
Conclusion: This study showed that concomitant TRUS-guided biopsy and TURP was safe and of possible clinical significance in urinary retention patients with elevated PSA.