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 w...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.展开更多
Background The specificity for early interventions of prostate-specific antigen （PSA） in prostate cancer （PCa） is not satisfactory.It is likely that prostate cancer antigen 3 （PCA3） can be used to predict biopsy...Background The specificity for early interventions of prostate-specific antigen （PSA） in prostate cancer （PCa） is not satisfactory.It is likely that prostate cancer antigen 3 （PCA3） can be used to predict biopsy outcomes more accurately than PSA for the early detection of PCa.We systematically reviewed literatures and subsequently performed a meta-analysis.Methods A bibliographic search in the database of Embase,Medline,Web of Science,NCBI,PubMed,CNKI,and those of health technology assessment agencies published before April 2013 was conducted.The key words used were ＂prostatic neoplasms＂,＂prostate＂,＂‘prostate,＇ ‘carcinoma＇ or ‘cancer＇ or ‘tumor＇,or ‘PCa,＇＂ and free terms of ＂upm3＂,＂pca3＂,＂dd3＂,＂aptimapca 3＂,and ＂prostate cancer antigen 3＂.All patients were adults.The intervention was detecting PCA3 in urine samples for PCa diagnosis.We checked the quality based on the QUADAS criteria,collected data,and developed a meta-analysis to synthesize results.Twenty-four studies of diagnostic tests with moderate to high quality were selected.Results The sensitivity was between 46.9％ and 82.3％; specificity was from 55％ to 92％; positive predictive value had a range of 39.0％-86.0％; and the negative predictive value was 61.0％-89.7％.The meta-analysis has heterogeneity between studies.The global sensitivity value was 0.82 （95％ Cl 0.72-0.90）; specificity was 0.962 （95％ Cl 0.73-0.99）; positive likelihood ratio was 2.39 （95％ Cl 2.10-2.71）; negative likelihood ratio was 0.51 （95％ Cl 0.46-0.86）; diagnostic odds ratio was 4.89 （95％ Cl 3.94-6.06）; and AUC in SROC curve was 0.744 1.Conclusion PCA3 can be used for early diagnosis of PCa and to avoid unnecessary biopsies.展开更多
文摘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.
文摘Background The specificity for early interventions of prostate-specific antigen （PSA） in prostate cancer （PCa） is not satisfactory.It is likely that prostate cancer antigen 3 （PCA3） can be used to predict biopsy outcomes more accurately than PSA for the early detection of PCa.We systematically reviewed literatures and subsequently performed a meta-analysis.Methods A bibliographic search in the database of Embase,Medline,Web of Science,NCBI,PubMed,CNKI,and those of health technology assessment agencies published before April 2013 was conducted.The key words used were ＂prostatic neoplasms＂,＂prostate＂,＂‘prostate,＇ ‘carcinoma＇ or ‘cancer＇ or ‘tumor＇,or ‘PCa,＇＂ and free terms of ＂upm3＂,＂pca3＂,＂dd3＂,＂aptimapca 3＂,and ＂prostate cancer antigen 3＂.All patients were adults.The intervention was detecting PCA3 in urine samples for PCa diagnosis.We checked the quality based on the QUADAS criteria,collected data,and developed a meta-analysis to synthesize results.Twenty-four studies of diagnostic tests with moderate to high quality were selected.Results The sensitivity was between 46.9％ and 82.3％; specificity was from 55％ to 92％; positive predictive value had a range of 39.0％-86.0％; and the negative predictive value was 61.0％-89.7％.The meta-analysis has heterogeneity between studies.The global sensitivity value was 0.82 （95％ Cl 0.72-0.90）; specificity was 0.962 （95％ Cl 0.73-0.99）; positive likelihood ratio was 2.39 （95％ Cl 2.10-2.71）; negative likelihood ratio was 0.51 （95％ Cl 0.46-0.86）; diagnostic odds ratio was 4.89 （95％ Cl 3.94-6.06）; and AUC in SROC curve was 0.744 1.Conclusion PCA3 can be used for early diagnosis of PCa and to avoid unnecessary biopsies.
