Transrektal ultrason eşliğinde prostat biyopsisinin komplikasyonlarını etkileyen faktörler: Tek bir merkezde 403 hasta ile yapılan kohort çalışma

Yıl 2019, , 183 - 186, 25.02.2019

Engin Kölükçü , Murat Beyhan Doğan Atılgan

https://doi.org/10.28982/josam.519931

Cited By: 1

Öz

Amaç: Prostat kanseri erkek populasyonda yaygın izlenen kanser türleri arasında yer almaktadır. Prostat kanseri tanısında transrektal ultrasonografi (TRUS) eşliğinde prostat biyopsi altın standart olarak gösterilmektedir. Çalışmamızda bu doku örnekleme metodunun komplikasyonları analiz edilmiştir.

Yöntemler: Çalışmada Aralık 2016 ile Kasım 2018 tarihleri arasında ilk defa TRUS eşliğinde 12 kor prostat biyopsisi yapılan 403 olgu değerlendirildi. Hastaların yaşları, parmakla rektal muayene bulguları, prostat spesifik antijen (PSA) düzeyleri, prostat hacimleri ve komplikasyonları değerlendirilmiştir.

Bulgular: Hastaların ortalama yaşı, serum total PSA düzeyi ve prostat hacmi sırasıyla 63,2 ± 8,53 yıl, 21,6 ± 18,19 ng/mL ve 65,63 ± 20,19 cc idi. İşlem sonrası hastaların %7,2’sinde genitoüriner sistem enfeksiyonu izlendi. Enfektif olmayan komplikasyonlara bakıldığında ise hastaların %23,1’inde hematüri, %16,1’inde hematospermi, %2,2’sinde rektal kanama gözlemlendi. Öte yandan hastaların %4,2’sinde vazovagal epizodlar ve %0,7’sinde ise akut üriner retansiyon ile karşılaşıldı. Çalışmaya alınan hastaların %8,9’u komplikasyonlara bağlı hospitalize edildi.

Sonuç: Prostat kanseri ön tanısı olan hastalarda TRUS eşliğinde prostat biyopsisinin düşük komplikasyon oranları ile güvenle kullanılabilecek bir tanı aracı olduğu düşüncesindeyiz.

Anahtar Kelimeler

Biyopsi, Komplikasyon, Prostat, Transrektal ultrason

Factors affecting complications of transrectal ultrasound-guided prostate biopsy: A cohort study with 403 patients in a single center

Öz

Aim: Prostate cancer is among the common cancer types in male population. Transrectal ultrasound (TRUS) guided prostate biopsy is considered the gold standard for diagnosis of prostate cancer. Complications in this tissue sampling method were analyzed in the present study.

Methods: A descriptive study with retrospective design was planned. A total of 403 patients who had 12 core TRUS guided prostate biopsy for the first time in December 2016 -November 2018 period were evaluated. Age of the patients, digital rectal examination finding, prostate specific antigen (PSA) levels, prostate volumes and complications were analyzed.

Results: Average age, serum total PSA level and prostate volume of patients were 63.2±8.53 years, 21.6±18.19 ng/mL and 65.63±20.19 cc, respectively. Genitourinary system infection was observed in 7.2% of the patients after the procedure. In terms of non-infection complications, 23.1% of patients had hematuria, 16.1% hematospermia and 2.2% rectal bleeding. On the other hand, 4.2% of the patients had vasovagal episodes and 0.7% had acute urinary retention. Of all patients, 8.9% were hospitalized due to observed complications.

Conclusion: We conclude that TRUS-guided prostate biopsy is a reliable diagnostic tool with low complication rates in patients with prostate cancer pre-diagnosis.

Anahtar Kelimeler

Biopsy, Complications, Prostate, Transrectal ultrasound

Kaynakça

• 1. Efesoy O, Bozlu M, Çayan S, Akbay E. Complications of transrectal ultrasound-guided 12-core prostate biopsy: a single center experience with 2049 patients. Turkish Journal of Urology. 2013;39(1):6-11. doi:10.5152/tud.2013.002.
• 2. Siegel R, Ma J, Zou Z, Jemal A. Cancer statistics, 2014. CA Cancer J Clin. 2014; 64:9-29.
• 3. Ferlay J, Parkin DM, Steliarova-Foucher E. Estimates of cancer incidence and mortality in Europe in 2008. Eur J Cancer. 2010;46(4):765-81. doi: 10.1016/j.ejca.2009.12.014.
• 4. Printz C. Many unknowns in low-risk prostate cancer treatment. Ongoing studies and biomarker research may shed light on best approach. Cancer. 2009;115(20): 4645-6.
• 5. Kolukcu E, Kilic S, Atılgan D. Comparison of two different anesthetic methods on pain perception in prostate biopsy. J Clin Anal Med. 2019;10(1):121-4.
• 6. Potosky AL, Miller BA, Albertsen PC, Kramer BS. The role of increasing detection in the rising incidence of prostate cancer. JAMA. 1995;15;273(7):548-52.
• 7. Çam K, Özveri H, Çevik İ, Türkeri L, Akdaş A. The Complications of Transrectal Ultrasound Guided Prostate Biopsy. T Klin Tip Bilimleri. 2001;21:282-84.
• 8. Takahashi H, Ouchi T. The ultrasonic diagnosis in the field of urology. Proc Jap Soc Ultrasonics Med. 1963;3-7.
• 9. Watanabe H, Igari D, Tanah asi Y, Harada K, Saito M. Development and application of new equipment for transrectal ultrasonography. J Clin Ultrasound. 1974;2(2):91-8.
• 10. Erturhan S, Seçkiner İ, Yağcı F, Erbağcı A, Solakhan M, Çelik M. Antibiotic Prophylaxis in Transrectal Ultrasound Guided Prostate Biopsy: Comparison of Two Different Antibıotic Schemes. Turkish Journal of Urology. 2007:33(4):487-90.
• 11. Hodge KK, McNeal JE, Stamey TA. Ultrasound guided transrectal core biopsies of the palpably abnormal prostate. J Urol. 1989;142:66-70.
• 12. Hodge KK, McNeal JE, Terris MK, Stamey TA. Random systematic versus directed ultrasound guided transrectal core biopsies of the prostate. J Urol. 1989;142:71-4.
• 13. Ellis WJ, Brawer MK. Repeat prostate needle biopsy: Who needs it? J Urol. 1995; 153:1496-8.
• 14. Norberg M, Evegad L, Holmberg L, Sparén P, Norlén BJ, Busch C. The sextant protocol for ultrasound-guided core biopsies of the prostate understimates the presence of cancer. Urology. 1997;50:562-6. doi:10.1016/S0090-4295(97)00306-3.
• 15. Erdemir F. Repeated Prostate Biopsies. Turk Urol Sem. 2011;2:223-31.
• 16. Dirim A, Tekin Mİ. TRUS biyopsi hazırlığı nasıl yapılmalıdır? Üroonkoloji Bülteni. 2010;2:21-24.
• 17. Rietbergen JB, Kruger AE, Kranse R, Schröder FH. Complications of transrectal ultrasound-guided systematic sextant biopsies of the prostate: evaluation of complication rates and risk factors within a population-based screening program. Urology. 1997;49(6):875-80. doi:10.1016/S0090-4295(97)00100-3.
• 18. Dede G, Şencan İ, Dede O, Şentürk G, Haykır A. Our experience on developing urinary tract infections after transrectal prostate biopsy. Dicle Medical Journal. 2014; 41(1):108-112. doi:10.5798/diclemedj.0921.2014.01.0382.
• 19. Naughton CK, Ornstein DK, Smith DS, Catalona WJ. Pain and morbidity of transrectal ultrasound guided prostate biopsy: a prospective randomized trial of 6 versus 12 cores. J Urol. 2000;163:168-71.
• 20. Berger AP, Gozzi C, Steiner H, Frauscher F, Varkarakis J, Rogatsch H, et al. Complication rate of transrectal ultrasound guided prostate biopsy: a comparison among 3 protocols with 6, 10 and 15 cores. J Urol. 2004;171:1478-80.
• 21. Atılgan D, Gençten Y, Kölükçü E, Kılıç Ş, Uluocak N, Parlaktaş BS, et al. Comparison between ciprofloxacin and trimethoprim-sulfamethoxazole in antibiotic prophylaxis for transrectal prostate biopsy. Turk J Urol. 2015;41(1):27–31. doi:10.5152/tud.2015.22120.
• 22. Bedir S, Kilciler M. Complications of transrectal ultrasound-Guided Prostate Biopsy. Turk Urol Sem. 2011;2:218-22.
• 23. Grabe M. Controversies in antibiotic prophylaxis in urology. Int J Antimicrob Agents. 2004;23:17-23.
• 24. Erkoç M, Beşiroğlu H, Danış E, Bozkurt M, Değirmentepe RB, Akkaş F, et al. Complication Rates in Patients Who Underwent Transrectal Ultrasound Guided Prostate Biopsy. Okmeydanı Tıp Dergisi. 2016;32(2):75-8.
• 25. Wu YP, Li XD, Ke ZB, Chen SH, Chen PZ, Wei Y, et al. Risk factors for infectious complications following transrectal ultrasound-guided prostate biopsy. Infect Drug Resist. 2018;11:1491–7. doi:10.2147/IDR.S171162.
• 26. Rodriguez LV, Terris MK. Risks and complications of transrectal ultrasound guided prostate needle biopsy: A prospective study and review of the literature. J Urol. 1998;160:2115-20.