Patient Reported Outcomes of Transperineal Prostate Biopsy With Tumescent Local Anesthesia.

Autor: Myrga JM; University of Pittsburgh Medical Center, Division of Health Services Research, Department of Urology, Pittsburgh, PA. Electronic address: myrgajm@upmc.edu., Erpenbeck SP; University of Pittsburgh, School of Medicine, Pittsburgh, PA., Watts A; University of Pittsburgh Medical Center, Division of Health Services Research, Department of Urology, Pittsburgh, PA., Stencel MG; University of Pittsburgh Medical Center, Division of Health Services Research, Department of Urology, Pittsburgh, PA., Staniorski CJ; University of Pittsburgh Medical Center, Division of Health Services Research, Department of Urology, Pittsburgh, PA., Patnaik S; University of Pittsburgh Medical Center, Division of Health Services Research, Department of Urology, Pittsburgh, PA., Yabes JG; Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA., Yu M; University of Pittsburgh Medical Center, Division of Health Services Research, Department of Urology, Pittsburgh, PA., Allaway MJ; Urology Associates and UPMC Western Maryland, Cumberland, MD., Gorin MA; Milton and Carroll Petrie Department of Urology at the Icahn School of Medicine at Mount Sinai, New York City, NY., Jacobs BL; University of Pittsburgh Medical Center, Division of Health Services Research, Department of Urology, Pittsburgh, PA., Davies BJ; University of Pittsburgh Medical Center, Division of Health Services Research, Department of Urology, Pittsburgh, PA.
Jazyk: angličtina
Zdroj: Urology [Urology] 2023 Dec; Vol. 182, pp. 33-39. Date of Electronic Publication: 2023 Sep 22.
DOI: 10.1016/j.urology.2023.09.010
Abstrakt: Objective: To report the outcomes of performing transperineal prostate biopsy in the office setting using the novel anesthetic technique of tumescent local anesthesia. We report anxiety, pain, and embarrassment of patients who underwent this procedure compared to patients who underwent a transrectal prostate biopsy using standard local anesthesia.
Materials and Methods: Consecutive patients undergoing either a transperineal prostate biopsy under tumescent local anesthesia or a transrectal prostate biopsy with standard local anesthetic technique were prospectively enrolled. The tumescent technique employed dilute lidocaine solution administered using a self-filling syringe. Patients were asked to rate their pain before, during, and after their procedure using a visual analog scale. Patient anxiety and embarrassment was assessed using the Testing Modalities Index Questionnaire.
Results: Between April 2021 and June 2022, 430 patients underwent a transperineal prostate biopsy using tumescent local anesthesia and 65 patients underwent a standard transrectal prostate biopsy. Patients who underwent a transperineal biopsy had acceptable but significantly higher pain scores than those who underwent a transrectal prostate biopsy (3.9 vs 1.6, P-value <.01). These scores fell to almost zero immediately following their procedure. Additionally, transperineal biopsy patients were more likely to experience anxiety (71% vs 45%, P < .01) and embarrassment (32% vs 15%, P < .01).
Conclusion: Transperineal biopsy using local tumescent anesthesia is safe and well-tolerated. Despite the benefits, patients undergoing a transperineal prostate biopsy under tumescent anesthesia still experienced worse procedural pain, anxiety, and embarrassment. Additional studies examining other adjunctive interventions to improve patient experience during transperineal prostate biopsy are needed.
Competing Interests: Declaration of Competing Interest Matthew Allaway: CEO of Perineologic. Michael Gorin: Former Paid Consultant for Perineologic. The other authors have no conflict of interest to declare.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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