Naslov
Is prostate biopsy more painful when there is pathological evidence of inflammation?

Autori
Sudarević, Bojan ; Radoja, Ivan ; Perković, Josip ; Rakin, Ivana ; Ćosić, Ivan ; Pavlović, Oliver ; Šimunović, Dalibor ; Galić, Josip

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
European Urology, Supplements / - Bratislava : Elsevier, 2010, 653-654

Skup
European Association of Urology 10th Central European Meeting

Mjesto i datum
Bratislava, Slovačka, 27.10.2010. - 28.10.2010

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
biopsy ; pain ; inflammation

Sažetak
Introduction Transrectal ultrasound-guided prostate needle biopsy is one of the mandatory diagnostic tests in detecting prostate cancer (CaP) and obtaining its histological confirmation. The procedure, which is mostly indicated when there is elevated serum PSA level and/or abnormal DRE, is generally not pleasant for the patient. Although intrarectal lidocaine application or periprostatic nerve block seem to reduce the pain during prostate biopsy, pathological finding of prostatitis brings a question whether the procedure is more painful when there is inflammation present. We evaluated and compared pain scores at the end of the biopsy between patients with histologically confirmed CaP and benign prostatic hyperplasia (BPH) and those with evidence of prostatic inflammation. Patients and Methods In 2009 we performed 340 consecutive transrectal prostate biopsies. The procedure was performed in an outpatient setting, with 500 mg of ciprofloxacin given orally one hour before the biopsy, no anesthesia and 12-core protocol. At the end of the procedure we measured patients' assessment of pain on a 10-point visual analogue scale (VAS). Hystological data were retrospectively analyzed, and the patients were divided into those with BPH, CaP and those with prostatitis (chronic/active). Descriptive statistical analysis was performed with an online statistical program (Kirkman, T.W. (1996) Statistics to Use. www.physics.csbsju.edu/stats/ (25 June 2010)), using Kolmogorov-Smirnov test for comparing datasets between the groups. P < 0.05 was considered statistically significant. Results Out of 340 prostate biopsies 83 patients had BPH, 114 CaP and 143 patients had evidence of prostatic inflammation on pathological analysis. Median age of all patients was 68 (range 42-84) ; all groups were age-matched. Median pain score on VAS was 3 for all groups. When comparing pain scores between prostatitis and CaP and BPH group, we found no statistically significant difference, with p=0.398 and p=0.980, respectively. Also, when CaP and BPH groups were joined, the difference in comparison with prostatitis group was nonsignificant (p=0.555). Discussion Although one would expect that prostate biopsy is more painful when there is histological evidence of prostatic inflammation present, recent studies suggest that chronic inflammation is a precursor in the development of CaP. Therefore, our results that the VAS pain score did not differ between the groups seem appropriate. Nevertheless, according to the evidence from randomized controlled trials, periprostatic nerve block is effective and safe in reducing pain from transrectal ultrasound biopsy of the prostate, even without taking pathological findings into account.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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