Sistematik ultrasonografi eşliğinde transrektal prostat biyopsisi yapılan hastalarda yaşın ağrı algısı üzerine etkisi

Abstract

Amaç: Transrektal ultrason eşliğinde prostat biyopsisinde (TRUS-PB) transrektal prob ve biyopsi iğnesinin prostat dokusuna yerleştirilmesi sonucu oluşan ağrı düzeylerine yaşın etkisini araştırmak. Gereç ve yöntem: Çalışmaya 308 hasta dahil edildi. Bu hastalar yaşlarına göre gruplara ayrıldı: Grup 1'de 65 yaş ve altı 103 hasta, Grup 2'de 66-70 yaş arası 100 hasta ve Grup 3'te 70 yaş üstü 105 hasta vardı. Çalışmaya dahil edilen hastalara anestezik olarak 11 ml %2'lik lidokain jel intrarektal olarak uygulandı. Biyopsi işleminden 30 dakika sonra her hastanın ağrısını, 0 (ağrı yok) ile 10 (en şiddetli ağrı) arasında değişen VAS skorunu kullanarak ölçtük. Hastalara rektal prob yerleştirilmesi ve manevralar sırasındaki ağrı düzeyi (VAS-p) ve biyopsi almak için iğnenin prostattan içeri sokulması sırasındaki ağrı düzeyi (VAS-b) soruldu. Bulgular: VAS-p skoru Grup 2'de diğer yaş gruplarına göre daha düşüktü. Gruplar VAS-b açısından değerlendirildiğinde 3 grup arasında anlamlı fark görülmedi. Tüm hastalarda probun yerleştirilmesi sırasında hissedilen ağrı biyopsi sırasında hissedilen ağrıdan daha fazlaydı ve bu istatistiksel olarak anlamlıydı (p=0,001). Prostat hacmi ağrı skoru ile karşılaştırıldığında, prostat hacmindeki her birim artış VAS-p'de ağrı olasılığını 1.014 kat artırıyordu. Sonuç: Biyopsi yapılan hastalarda ağrı duyusunun çoğunlukla prob yerleştirilmesi sırasında hissedildiği ve bu ağrı duyusunun prostat büyüklüğü arttıkça arttığı görülmektedir.

Keywords

• Ağrı skoru
• anestezi
• prostat biyopsisi
• transrektal ultrason

The effect of age on pain perception among patiens undergoing systematic ultrasonography guided transrectal prostate biopsy

Abstract

Purpose: To investigate the effect of age on the pain levels caused by placing the transrectal probe and biopsy needle into the prostate tissue in transrectal ultrasound-guided prostate biopsy (TRUS-PB). Materials and methods: The study included 308 patients. These patients were divided into groups based on age: Group 1 had 103 patients aged 65 or younger, Group 2 had 100 patients aged 66-70, and Group 3 had 105 patients over 70. 11 ml 2% lidocaine gel was administered intrarectally to the patients included in the study as anesthesia. Thirty minutes after the biopsy procedure, we measured each patient's pain using the VAS score, which ranged from 0 (no pain) to 10 (worst pain). Patients were asked for pain level during the insertion of the rectal probe and the maneuvers (VAS-p) and the pain level during the insertion of the needle through the prostate to take a biopsy (VAS-b). Results: VAS-p score was lower in Group 2 than in the other age groups. When the groups were evaluated in terms of VAS-b, no significant difference was observed between the 3 groups. Across all patients, the pain felt during probe insertion was greater than the pain felt during biopsy and this was statistically significant (p=0.001). When prostate volume was compared with pain score, each unit increase in prostate volume increased the probability of pain in VAS-p by 1.014 times. Conclusion: Pain sensation in patients undergoing biopsy is mainly felt during probe insertion, and that this pain sensation increases with increasing prostate size.

Keywords

• Anesthesia
• pain score
• prostate biopsy
• transrectal ultrasound

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