Prostat biyopsisi yaşlılarda güvenli mi?

Öz

Amaç : Prostat kanseri tanısında yaygın olarak kullanılan transrektal ultrason (TRUS) eşliğinde prostat iğne biyopsisinin yaşlı hastalarda ne kadar güvenli olduğunu ve görülen komplikasyonların genç hastalardan farkını ortaya koymayı amaçladık. Materyal-metod : 2017-2020 arasında prostat biyopsisi yapılan 515 hasta çalışmaya dahil edildi. Tüm hastaların demografik verileri, ek hastalıkları, laboratuar bulguları, prostat hacimleri, prostat biyopsisi patoloji sonuçları, biyopsi sonrası gelişen komplikasyonlar retrospektif olarak incelendi. Hastalar 65 yaş altı olanlar grup 1 ve 65 yaş üstü olanlar grup 2 olarak 2 gruba ayrıldı. Her iki grupta prostat biyopsisi sonrası görülen komplikasyonlar karşılaştırıldı. Bulgular : Grup 1’de 244, grup 2’de ise 271 hasta vardı. Grup 1 yaş ortalaması 59,50±3,98, grup 2 yaş ortalaması 71,45±4,57 idi. Grup 1’de 5 hastada biyopsi sonrası ateş (%2), 44 hastada hematüri (%18), 79 hastada hematospermi (%32,4), 7 hastada ise rektal kanama (%2,9) izlendi. Grup 2’de ise 15 hastada biyopsi sonrası ateş (%5,5), 69 hastada hematüri (%25,5), 21 hastada hematospermi (%7,7), 11 hastada rektal kanama (%4,1) görüldü. Ancak bu komplikasyonlar dışında grup 1’de 2 hastada (%0,2), grup 2’de 6 hastada (%2,2) ciddi sepsis bulguları izlendi ve hastalar hospitalize edilerek tedavi edildi. Prostat biyopsisi sonrası komplikasyon görülmesini etkileyen risk faktörlerini incelemek için yapılan logistik regresyon analizinde yaş , PSA ve PSA dansitesi yükseldikçe komplikasyon görülme riskinin anlamlı olarak arttığını tespit ettik. Sonuç : Sonuç olarak çalışmamızda yaşlı hastalarda komplikasyon görülme riskinin daha yüksek olduğunu ve görülen komplikasyonların daha ciddi olabileceğini ortaya koyduk. Bu nedenle yaşlı hastalarda prostat biyopsisi öncesi ve sonrası komplikasyon gelişimini önlemek için daha dikkatli yaklaşmak gerektiğini düşünmekteyiz.

Anahtar Kelimeler

• Yaşlı
• iğne biyopsisi
• prostat

Is prostate biopsy safe in the elderly?

Abstract

Aim : It was aimed to reveal how safe the transrectal ultrasound guided prostate needle biopsy, which is commonly used in the diagnosis of prostate cancer, was in elderly patients, and the difference of complications from young patients. Material-method: 515 patients, who underwent prostate biopsy between 2017-2020, were included in the study. All patients' demographic data, comorbidities, laboratory findings, prostate volumes, prostate biopsy pathology results, and post-biopsy complications were retrospectively analyzed. The patients were divided in 2 groups: group-1 consisting of patients under the age of 65 and group-2 with above the age of 65. Results: There were 244 patients in group-1 and 271 in group-2. The mean age of group-1 was 59.50±3.98, group-2 was 71.45±4.57. In group-1, post-biopsy fever was observed in 5 patients (2%), hematuria in 44 (18%), hematospermia in 79 (32.4%), and rectal bleeding in 7 (2.9%). In group-2, post-biopsy fever was observed in 15 patients (5.5%), hematuria in 69 (25.5%), hematospermia in 21 (7.7%), and rectal bleeding in 11 (4.1%). Severe sepsis findings were observed in 2 patients (0.2%) in group-1 and 6 (2.2%) in group-2. In the logistic-regression-analysis it was determined that the risk of complication increased significantly as the age, PSA and PSA density increased. Conclusion: In our study it was revealed that the risk of complications was higher in elderly and that the complications observed may be more serious. Therefore, we consider that a more careful approach should be taken in elderly patients to prevent the complications before and after prostate biopsy.

Keywords

• Aged
• needle biopsy
• prostate

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