經會陰攝護腺切片與經直腸攝護腺切片相比有更低的感染併發症
黃冠霖1、江博暉2
高雄長庚醫院泌尿科
Trans-perineal prostate biopsy: Less infection complications than trans-rectal prostate biopsy.
Guan-Lin Huang, M.D1. , Po-Hui Chiang, M.D. Ph.D. 2
Division of Urology , Kaohsiung Chang Gung Memorial Hospital, Taiwan.
Purpose: Comparisons of the prostate cancer detection rate and post biopsy complications between the transrectal(TR) and transperineal(TP) prostate biopsy.
Materials and methods: 156 patients indicated for prostate biopsy(PSA >4ng/dl, DRE abnormal finding, and suspicious prostate cancer reccurence) were prospectively informed from 2015/11 to 2017/2 and collected for characteristics as age, PSA level, number of biopsy, prophylaxis antibiotics use, NRS pain score, hematuria, infection related complication and cancer detection rate between transperineal(TP) and transrectal(TR) prostate biopsy group. Trans-perineal biopsy(TP) was performed by trans-rectal ultrasound guided localization with systemic 8 cores targeting the peripheral zones and 2 cores over the transitional zone. Intravenous general anesthesia or local lidocaine injection (peri-prostate nerve block approach) was chosen by patient preference. Chi-square analysis was used for infection related complication and prostate cancer detection rate. Student T-test was used for comparing the NRS pain score between these two groups.
Results: We collected respectively 78 patients in TP and TR group. There are no statistical significance in cancer detection rate, hematuria and acute urine retention in these two groups. Prostatitis and hospitalization due to post biopsy complication were significantly higher in TR group.
Conclusions: Comparable cancer detection rate in these 2 biopsy approach. However, TP has advantages over TR on infection related complicaitons.