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Transrectal-ultrasound prostatic biopsy preparation: rectal enema vs. mechanical bowel preparation.

De Nunzio C, Lombardo R, Presicce F, Bellangino M, Finazzi Agro E, Gambrosier MB, Trucchi A, Petta S, Tubaro A - Cent European J Urol (2015)

Bottom Line: No significant differences for low-grade and high-grade complications was observed between the two groups.Patients receiving the rectal enema presented with a significantly lower VAS score (3.1 ±1.1 vs. 5.9 ±1.7; p = 0.02).Our study confirmed that a rectal enema should be considered as the standard bowel preparation in patients undergoing a TRUS biopsy; it is as effective as PEG and associated with less discomfort.

View Article: PubMed Central - PubMed

Affiliation: Ospedale Sant'Andrea, La Sapienza, Roma, Italia.

ABSTRACT

Introduction: Transrectal prostate biopsy (TRUSbx) is the standard for the diagnosis of prostate cancer. Different bowel preparations are used for patients undergoing TRUSbx. The aim of our study was to compare two different bowel preparations for TRUSbx.

Material and methods: From May 2012 and onwards, a selected group of men undergoing TRUS 12-core prostate biopsy were enrolled into a prospective database. Patients were randomized 1:1 to receive a rectal enema (Group A) the night before the procedure or polyethylene glycol 34.8 grams/4 liters of water the day before the procedure (Group B). A VAS scale to evaluate the patients' discomfort according to the two preparations was collected. The same antibiotic prophylaxis was performed in both groups. All complications were prospectively recorded and graded according to the Clavien Classification System (CCS).

Results: A total of 198 patients were consecutively enrolled. Mean age was 67.5 ±7.9 years, mean body mass index (BMI) was 27.1 ±4.2 Kg/m(2), mean PSA value was 9.3 ±12.6 ng/ml and the mean prostatic volume was 60.6 ±29 ml. 97 patients were enrolled in Group A and 101 in Group B. Overall post-biopsy morbidity rate was 60%. No significant differences for low-grade and high-grade complications was observed between the two groups. Patients receiving the rectal enema presented with a significantly lower VAS score (3.1 ±1.1 vs. 5.9 ±1.7; p = 0.02).

Conclusions: Our study confirmed that a rectal enema should be considered as the standard bowel preparation in patients undergoing a TRUS biopsy; it is as effective as PEG and associated with less discomfort.

No MeSH data available.


Related in: MedlinePlus

Randomization flow-chart.
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Figure 0001: Randomization flow-chart.

Mentions: Overall 215 patients were enrolled at baseline, 198 were available. The study flow chart is shown in Figure 1. Out of these 97/198 patients (49%) underwent TRUSbx with an enema preparation while 101/198 (51%) patients underwent PEG preparation. Characteristics of the cohort are summarized in Table 1. Overall the median age was 68 (62/74) years, the median PSA was 6.8 (5.1/9.7) ng/ml and the median TRUS volume was 56.0 (35.9/82.0) ml. Overall 86/198 (43%) patients had cancer on biopsy. No differences between the groups was observed besides a significantly lower VAS score in patients receiving the rectal enema versus the PEG (3.1 ±1.1 vs. 5.9 ±1.7; p = 0.02) (Table 1).


Transrectal-ultrasound prostatic biopsy preparation: rectal enema vs. mechanical bowel preparation.

De Nunzio C, Lombardo R, Presicce F, Bellangino M, Finazzi Agro E, Gambrosier MB, Trucchi A, Petta S, Tubaro A - Cent European J Urol (2015)

Randomization flow-chart.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4526619&req=5

Figure 0001: Randomization flow-chart.
Mentions: Overall 215 patients were enrolled at baseline, 198 were available. The study flow chart is shown in Figure 1. Out of these 97/198 patients (49%) underwent TRUSbx with an enema preparation while 101/198 (51%) patients underwent PEG preparation. Characteristics of the cohort are summarized in Table 1. Overall the median age was 68 (62/74) years, the median PSA was 6.8 (5.1/9.7) ng/ml and the median TRUS volume was 56.0 (35.9/82.0) ml. Overall 86/198 (43%) patients had cancer on biopsy. No differences between the groups was observed besides a significantly lower VAS score in patients receiving the rectal enema versus the PEG (3.1 ±1.1 vs. 5.9 ±1.7; p = 0.02) (Table 1).

Bottom Line: No significant differences for low-grade and high-grade complications was observed between the two groups.Patients receiving the rectal enema presented with a significantly lower VAS score (3.1 ±1.1 vs. 5.9 ±1.7; p = 0.02).Our study confirmed that a rectal enema should be considered as the standard bowel preparation in patients undergoing a TRUS biopsy; it is as effective as PEG and associated with less discomfort.

View Article: PubMed Central - PubMed

Affiliation: Ospedale Sant'Andrea, La Sapienza, Roma, Italia.

ABSTRACT

Introduction: Transrectal prostate biopsy (TRUSbx) is the standard for the diagnosis of prostate cancer. Different bowel preparations are used for patients undergoing TRUSbx. The aim of our study was to compare two different bowel preparations for TRUSbx.

Material and methods: From May 2012 and onwards, a selected group of men undergoing TRUS 12-core prostate biopsy were enrolled into a prospective database. Patients were randomized 1:1 to receive a rectal enema (Group A) the night before the procedure or polyethylene glycol 34.8 grams/4 liters of water the day before the procedure (Group B). A VAS scale to evaluate the patients' discomfort according to the two preparations was collected. The same antibiotic prophylaxis was performed in both groups. All complications were prospectively recorded and graded according to the Clavien Classification System (CCS).

Results: A total of 198 patients were consecutively enrolled. Mean age was 67.5 ±7.9 years, mean body mass index (BMI) was 27.1 ±4.2 Kg/m(2), mean PSA value was 9.3 ±12.6 ng/ml and the mean prostatic volume was 60.6 ±29 ml. 97 patients were enrolled in Group A and 101 in Group B. Overall post-biopsy morbidity rate was 60%. No significant differences for low-grade and high-grade complications was observed between the two groups. Patients receiving the rectal enema presented with a significantly lower VAS score (3.1 ±1.1 vs. 5.9 ±1.7; p = 0.02).

Conclusions: Our study confirmed that a rectal enema should be considered as the standard bowel preparation in patients undergoing a TRUS biopsy; it is as effective as PEG and associated with less discomfort.

No MeSH data available.


Related in: MedlinePlus