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Patient-reported pain, discomfort, and anxiety during magnetic resonance imaging-targeted prostate biopsy

Artikel i vetenskaplig tidskrift
Författare G. T. Chesnut
P. Zareba
D. D. Sjoberg
M. Mamoor
Sigrid Carlsson
T. Lee
J. Fainberg
E. Vertosick
M. Manasia
M. Schoen
B. Ehdaie
Publicerad i Canadian Urological Association Journal
Volym 14
Nummer/häfte 5
ISSN 1920-1214
Publiceringsår 2020
Publicerad vid Institutionen för kliniska vetenskaper, Avdelningen för urologi
Språk en
Länkar dx.doi.org/10.5489/CUAJ.6102
Ämnesord adult, anxiety, article, controlled study, correlation coefficient, human, major clinical study, male, nerve block, nuclear magnetic resonance imaging, numeric rating scale, prostate biopsy, transrectal ultrasonography
Ämneskategorier Urologi och njurmedicin, Radiologi och bildbehandling

Sammanfattning

Introduction: The addition of targeted prostate biopsy to systemic biopsy impacts patient experience. We examined patient-reported pain, discomfort, anxiety, and tolerability among men undergoing magnetic resonance imaging (MRI)-targeted prostate biopsy in addition to transrectal ultrasound-guided systematic biopsy compared to those undergoing systematic biopsy alone. Methods: All patients underwent transrectal systematic 14-core biopsies. Patients with regions of interest on MRI underwent additional targeted biopsies. All patients received equivalent periprostatic nerve block. Four single-item, standard 11-point numerical rating scales evaluating pain, discomfort, anxiety, and tolerability were completed immediately after biopsy. Differences in means were compared using t-tests. Correlation between rated domains was tested using Spearman's correlation coefficient. Results: Of 273 consecutive patients, 195 (71%) underwent targeted biopsy and 188 (69%) had undergone prior biopsy. In all men, the median score for pain and tolerability was 3, while the median score for discomfort and anxiety was 4. Pain was rated at 7 or above by 15% of patients. Moderate correlation between pain, discomfort, anxiety, and tolerability of repeat biopsy was observed (Spearman's ρ between 0.48 and 0.76). Compared to patients undergoing systematic biopsy alone, men who received both targeted and systematic biopsies reported higher anxiety scores (difference 1.2; 95% confidence interval [CI] 0.4-2.0; p=0.004) and discomfort (difference 1.0; 95% CI 0.3-1.7; p<0.001). Conclusions: Patients undergoing targeted and systematic biopsies report more discomfort and anxiety than patients undergoing systematic biopsies alone. Absolute differences are small, and patients are willing to undergo repeat biopsy if advised. Interventions to reduce biopsy-related anxiety are needed. © 2020 Canadian Urological Association. All rights reserved.

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