从经直肠转经会阴路线:单中心体验。

IF 0.8 4区 医学 Q4 UROLOGY & NEPHROLOGY Progres En Urologie Pub Date : 2024-01-01 Epub Date: 2023-09-28 DOI:10.1016/j.purol.2023.09.006
A Brun, C Klein, G Capon, E Alezra, V Estrade, P Blanc, J C Bernhard, F Bladou, G Robert
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引用次数: 0

摘要

引言:本研究旨在评估既往没有经直肠前列腺活检经验的泌尿科医生将经直肠前列腺穿刺术改为经会阴前列腺活检术(TPPBx)的可行性。材料在2021年1月至11月期间进行了一项单中心临床研究,包括105名连续患者,他们接受了由两名先前没有TPPBx经验的资深泌尿科医生进行的TPPBx(GR,FB)。活检是在局部麻醉(LA)下进行的,没有抗菌药物。主要目的是评估该程序的安全性。根据Clavien-Dindo评分对不良事件进行分类。次要目标是使用评分量表(NRS)评估不同步骤过程中的疼痛程度、检测到的临床显著性前列腺癌症(csPCa)发生率以及使用医院焦虑和抑郁量表(HAD)评估焦虑程度。结果:无重大并发症(Clavien-Dindo评分≥3)报告。一名患者出现急性尿潴留(1%)和尿路感染(1%)。其他不良事件包括血尿(43%)、血精症(23%)、直肠出血(1%)、会阴血肿(3%)、持续性会阴疼痛(5%)和新发性勃起功能障碍(2%)。该手术的NRS疼痛中位水平为2.00(智商:1.00-4.00);在LA期间为3.00(IQ:2.00-5.00),在标点期间为3.00(IQ:2.00-5.00)。在焦虑患者(HAD评分>10)中,手术过程中的疼痛程度为2.5(IQ:2.00-3.00)。总体而言,63%的患者检测到csPCa。结论:即使由以前没有TPPBx经验的泌尿科医生进行,在没有抗肥大的LA下进行TPPBx也能提供很少的并发症、可接受的疼痛阈值和令人满意的csPCa检测率。证据级别:3:
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Switching from the transrectal to the transperineal route: A single center experience.

Introduction: This study aimed to evaluate the feasibility of switching from transrectal to transperineal prostate biopsy (TPPBx) by urologists with no previous experience with TPPBx. Material A monocentric clinical study with exhaustive and consecutive inclusions was conducted between January and November 2021, including 105 consecutive patients who underwent TPPBx performed by two senior urologists with no previous experience of TPPBx (GR, FB). Biopsies were performed under local anesthesia (LA) without antibioprophylaxis. The main objective was to assess the safety of this procedure. Adverse events were classified according to the Clavien-Dindo score. The secondary objectives were to assess the level of pain experienced during the different steps of the procedure using a numerating rating scale (NRS), the rate of clinically significant prostate cancer (csPCa) detected, and the level of anxiety using the Hospital Anxiety and Depression Scale (HAD).

Results: No major complications (Clavien-Dindo score≥3) were reported. One patient presented with acute urinary retention (1%) and a urinary tract infection (1%). Other adverse events were hematuria (43%), hemospermia (23%), rectal bleeding (1%), perineal hematoma (3%), persistent perineal pain (5%), and de novo erectile dysfunction (2%). The median level of pain on NRS for the procedure was 2.00 (IQ: 1.00-4.00); it was 3.00 (IQ: 2.00-5.00) during LA and 3.00 (IQ: 2.00-5.00) during punctions. In anxious patients (HAD score>10), the level of pain during the procedure was 2.5 (IQ: 2.00-3.00). Overall, csPCa was detected in 63%.

Conclusion: TPPBx under LA without antibioprophylaxis provides few complications, an acceptable pain threshold, and a satisfactorily rate of csPCa detection, even if performed by urologists with no previous experience of TPPBx.

Level of evidence: 3:

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来源期刊
Progres En Urologie
Progres En Urologie 医学-泌尿学与肾脏学
CiteScore
1.80
自引率
27.30%
发文量
132
审稿时长
54 days
期刊介绍: Une publication rapide des travaux en urologie: retrouvez les derniers travaux de recherche, études et enquêtes, en Urologie, publiés sous la forme de revues, mises au point, articles originaux, notes techniques, cas cliniques pertinents et originaux, lettres à la rédaction, revues de la littérature, textes de recommandation,... La revue publie également des articles pour les infirmières en Urologie. Une approche pluridisciplinaire : Progrès en Urologie aborde toutes les pathologies urologiques. Aux 13 numéros de Progrès viennent s''ajouter 4 numéros de Progrès en Urologie Pelvi-Périnéologie
期刊最新文献
Mini-percutaneous nephrolithotomy: Is smaller better for kidney stones in patients with neurogenic bladder? New protocol in the treatment of Peyronie's disease by combining platelet-rich plasma, percutaneous needle tunneling, and penile modeling: Preliminary results. Active surveillance in favorable intermediate-risk prostate cancer: A single-center experience. Switching from the transrectal to the transperineal route: A single center experience. Evaluation of local control after percutaneous microwave ablation versus partial nephrectomy: A propensity score matched study.
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