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Transperineal prostate biopsies for diagnosis of prostate cancer are well tolerated： a prospective study using patient-reported outcome measures

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Asian Journal of Andrology 2017年第1期19卷 62-66页

作者： Karan Wadhwa Lina Carmona-Echeveria timur kuru Gabriele Gaziev Eva Serrao Deepak Parasha Julia Frey Ivailo Dimov Jonas Seidenader Pete Acher Gordon Muir Andrew Doble Vincent Gnanapragasam Boris Hadaschik Christof Kastner Department of Urology Addenbrookes Hospital Cambridge UK Department of Urology University Hospital Heidelberg Germany Department of Biochemistry University of Cambridge Cambridge UK Cancer Research Centre and Statistics and Epidemiology Unit Division of Health Sciences Warwick Medical School University of Warwick Coventry UK Department of Urology Southend University Hospital Southend UK Department of Urology Kings College Hospital London UK CamPARI Prostate Cancer Clinic Addenbrookes Hospital Cambridge UK.

We aimed to determine short-term patient-reported outcomes in men having general anesthetic transperineal （TP） prostate biopsies. A prospective cohort study was performed in men having a diagnostic TP biopsy. This was done using a validated and adapted questionnaire immediately post-biopsy and at follow-up of between 7 and 14 days across three tertiary referral hospitals with a response rate of 51.6%. Immediately after biopsy 43/201 （21.4%） of men felt light-headed, syncopal, or suffered syncope. Fifty-three percent of men felt discomfort after biopsy （with 95% scoring 〈5 in a 0-10 scale）. Twelve out of 196 men （6.1%） felt pain immediately after the procedure. Despite a high incidence of symptoms （e.g., up to 75% had some hematuria, 47% suffered some pain）, it was not a moderate or serious problem for most, apart from hemoejaculate which 31 men suffered. Eleven men needed catheterization （5.5%）. There were no inpatient admissions due to complications （hematuria, sepsis）. On repeat questioning at a later time point, only 25/199 （12.6%） of men said repeat biopsy would be a significant problem despite a significant and marked reduction in erectile function after the procedure. From this study, we conclude that TP biopsy is well tolerated with similar side effect profiles and attitudes of men to repeat biopsy to men having TRUS biopsies. These data allow informed counseling of men prior to TP biopsy and a benchmark for tolerability with local anesthetic TP biopsies being developed for clinical use.

关键词： attitude to rebiopsy patient-reported outcome measures patient satisfaction prostate cancer diagnosis transperineal biopsies transrectal biopsies

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Prostate magnetic resonance imaging at 3 Tesla:Is administration of hyoscine-N-butyl-bromide mandatory?

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World Journal of Radiology 2013年第7期5卷 259-263页

作者： Matthias C Roethke timur H kuru Alexander Radbruch Boris Hadaschik Heinz-Peter Schlemmer Department of Radiology German Cancer Research Center Heidelberg (DKFZ) 69120 Heidelberg Germany Department of Urology Universityhospital Heidelberg 69120 Heidelberg Germany

AIM: To evaluate the value of administration of hyoscine-N-butyl-bromide (HBB) for image quality magnetic resonance imaging (MRI) of the prostate. METHODS: Seventy patients were retrospectively included in the study. Thirty-five patients were examined with administration of 40 milligrams of HBB (Buscopan ; Boehringer, Ingelheim, Germany); 35 patients were examined without HBB. A multiparametric MRI protocol was performed on a 3.0 Tesla scanner without using an endorectal coil. The following criteria were evaluated independently by two experienced radiologists on a five-point Likert scale: anatomical details (delineation between peripheral and transitional zone of the prostate, visualisation of the capsule, depiction of the neurovascular bundles); visualisation of lymph nodes; motion related artefacts; and overall image ***: Comparison of anatomical details between the two cohorts showed no statistically significant difference (3.9 ± 0.7 vs 4.0 ± 0.9, P = 0.54, and 3.8 ± 0.7 vs 4.2 ± 0.6, P = 0.07) for both readers. There was no significant advantage regarding depiction of local and iliac lymph nodes (3.9 ± 0.6 vs 4.2 ± 0.6, P = 0.07, and 3.8 ± 0.9 vs 4.1 ± 0.8, P = 0.19). Motion arte- facts were rated as 'none' to 'few' in both groups and showed no statistical difference (2.3 ± 1.0 vs 1.9 ± 0.9, P = 0.19, and 2.3 ± 1.1 vs 1.9 ± 0.7, P = 0.22). Overall image quality was rated 'good' in average for both cohorts without significant difference (4.0 ± 0.6 vs 4.0 ± 0.9, P = 0.78, and 3.8 ± 0.8 vs 4.2 ± 0.6, P = 0.09). CONCLUSION: The results demonstrated no significant effect of HBB administration on image quality. The study suggests that use of HBB is not mandatory for MRI of the prostate at 3.0 Tesla.

关键词： Butylscopolamine Buscopan Motion artefacts Magnetic resonance imaging Prostate cancer 3 Tesla

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孤立肾模型中热缺血时间对肾部分切除术后长期肾功能的影响

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微创泌尿外科杂志 2014年第2期3卷 68-72页

作者： Sascha Pahernik 朱捷隗英琦 Zeier Martin Gencay Hatiboglu Gita Schoenberg timur kuru Tobias Simpfendrfer 张旭 Markus Hohenfellner 德国海德堡大学医学院临床医院泌尿外科德国海德堡999035 中国人民解放军总医院泌尿外科中国北京大学医学部公共卫生学院流行病和卫生统计学系德国海德堡大学医学院临床医院肾脏中心

目的：热缺血时间对肾部分切除术后肾功能的影响仍然存在争议,探讨热缺血时间对肾部分切除术后长期肾功能的影响.方法：回顾性研究海德堡大学医学院泌尿外科1984年8月~2011年7月收治75名孤立肾患者实施的83例肾部分切除术,评估热缺血时... 详细信息

目的：热缺血时间对肾部分切除术后肾功能的影响仍然存在争议,探讨热缺血时间对肾部分切除术后长期肾功能的影响.方法：回顾性研究海德堡大学医学院泌尿外科1984年8月~2011年7月收治75名孤立肾患者实施的83例肾部分切除术,评估热缺血时间、术前肾功能基线水平、切除的正常肾组织体积对术后长期肾功能水平和变化的影响.结果：平均术前肾功能57.41 ml/mi n per 1.73 m2,平均热缺血时间为18.04 mi n ,平均切除的正常肾组织体积为18.79 c m3,平均随访时间69.39个月.多因素分析不同术前肾功能基线水平的各组在术后12个月时差异有统计学意义(P ＝0.01)；围手术期的急性肾衰竭事件明显而持续影响术后的肾功能水平(12个月 P ＝0.001,60个月 P ＝0.03)；而热缺血时间各分组和切除的正常肾组织体积与术后肾功能水平无关联.围手术期急性肾衰竭事件在术后12个月时明显影响术后肾功能的变化(P ＜0.01),切除的正常肾组织体积各组在整个随访期均保持显著差异(12个月 P ＝0.03,36个月 P ＜0.01,60个月 P ＜0.01).结论：术前肾脏质量和术后肾脏的体积是最重要的术后长期肾功能危险因素,术前肾功能基线水平决定术后肾功能的水平,术后存留的肾脏体积决定术后肾功能恢复的能力；围手术期急性肾衰竭事件是新发现的术后长期肾功能的风险因子；热缺血时间虽然与术后长期肾功能无直接关联,但可以通过增加围手术期急性肾衰竭事件的风险间接影响术后肾功能的水平和恢复能力.

关键词：孤立肾热缺血时间肾部分切除术肾功能

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