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1999 Selected Abstracts from American Urological Association annual meeting

Complications and Quality of Life Impairment After Ultrasound Guided Prostate Biopsy - A Prospective Study

A Zisman, D Leibovici, YI Siegel and A Lindner; Zerifin, Israel. (Presented by Dr. Zisman)
Introduction and Objectives:
The study aim was to monitor and assess morbidity associated with the process of transrectal ultrasound guided prostate biopsy (TRUSgBx).
Methods:
98 consecutive biopsies were enrolled. A questionnaire was filled in 3 consecutive appointments. Patients mean age was 67±9 years. The PSA median was 8.2 ng/ml.. CAP was diagnosed in 27% of cases. The mean Gleason's score was 6.4±1.5. Patients were given prophylactic antibiotic treatment starting 24h' before the biopsy (89% quinolones and 10% cephalosporin).
Results:
Before biopsy: 9% of the patients attributed a sexual impairment resulting from anticipation for the biopsy scheduled. 65% of patients reported anxiety prior to biopsy, leading to the use of a anxiolytic agent in 5.3%. During biopsy: 96% and 86% of the patients reported pain and discomfort, respectively: mild in 42% and 28% and severe in 16% and 30%, respectively.
Half of the patients reported pain and discomfort different from what they expected, in Two thirds it was less than they expected. After the biopsy: 48% and 21% of patients, respectively, reported pelvic pain lasting 1-2 days. 14% used analgesic agents. 50% of the patients were still employed. A total sum of 25 working days were lost by 22% of the patients who were still employed. 58% reported hematuria starting immediately and subsiding after 5.6±7.7 days.
Hematospermia was reported by 51% and continued for 13.2±12.4 days. Rectal bleeding was reported by 40% and continued for 2.1±1.8 days. 25% of the patients reported mild voiding difficulties and additional 4.5% presented with acute urinary retention. 5 patients had fever (38.5±1.03) resulting in admission in 4(4.2%). One of these patients had severe sepsis. 21% and 20% of the patients reported sexual impairment and decreased libido, respectively. 75% of the patients reported anxiety during the period awaiting for the histological report, mandating the use of anxiolytic agents in 13%.
Conclusions:
Prostate biopsy commonly causes a vast variety of complications and has a substantial impact on the patients well being.
Source of Funding: Departmental.
Source: 1999 AUA Meeting

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