無麻酔下経直腸前立腺針生検における疹痛に関する検討

Abstract

Multiple-core biopsy protocols are now accepted as general practice for detecting early prostate carcinomas. We have increased the number of samples taken from 6 to 10 cores since January of 2003. We prospectively evaluated the influence of increasing the nurnber of cores upon the degree of pain experienced during the procedure. Materials and Methods : A total of 178 men who underwent a prostate biopsy of 10 cores were included in the analysis. The degree of pain was assessed by means of a ten- point pain score following probe insertion, after 6 cores were obtained, and after 10 cores were obtained. Factors analyzed included age, prostate volirme, body mass index, pathological results of the biopsy, differences in the pain score at the time of probe insertion, and medical history of prostate biopsy. Results : The average pain score after 10 cores was significantly higher than that after 6 cores (5.01 vs 4.49, p=O.OOI), which, in turn, was significantly higher than that following probe insertion(4.49 vs 4.07,p=O.046). Patients with a history of prostate biopsy had significantly higher average pain scores than those without a previous experience, both after 6 cores (5.16 vs 4.35, p=O.046) and after 10 cores (5.94 vs 4.84, p=O.029), while no significant difference existed after probe insertion. Again, patients with a pain score of 5 or more after probe insertion had significantly higher average pain scores than those with a pain score of 4 or less after 6 cores (5.21 vs 3.89, p〈O.OOI). Conclusions : A medical history of prostate biopsy and pain experienced upon probe insertion are important factors which intensify the degree of pain an examinee will experience during the procedure.