Clinical Value Of Transperineal Prostate Biopsy Guided By Abdominal Probe In Special Patients

Objective Prostate cancer(PCa)is currently one of the most common malignant tumors in men.Prostate biopsy is the "gold standard" for diagnosis.Currently,the commonly used method of biopsy is transrectal ultrasound(TRUS)guided transperineal or transperineal Rectal puncture.For patients with severe hemorrhoids,anal fissures,anal stenosis,or lower rectal tumors after surgery,there is still a lack of clinically reliable,effective and convenient methods for prostate puncture.This article aims to analyze the application value of transperineal prostate biopsy guided by abdominal probe in patients with increased PSa and severe hemorrhoids,anal fissures,anal stenosis,or lower rectal tumors after surgery.MethodThis study is a retrospective study.The preoperative biopsy and examination data of the Quanzhou First Hospital Affiliated to Fujian Medical University from April 2017to April 2020 were selected for PCa.Prostate MRI enhancement examinations were performed before surgery to confirm suspicious lesions.PCa-confirmed patients with elevated PSa combined with severe hemorrhoids,anal fissures,anal stenosis,or lower rectal tumors after surgery were used as the observation group.Observed patients underwent abdominal probe-guided transperineal prostate biopsy.The PCaconfirmed patients who underwent rectal ultrasound-guided transrectal prostate biopsy served as the control group.And collect the laboratory test data of all patients,including the detection of total PSa(t PSa),free PSa(f PSa),and calculate the ratio of f PSa to t PSa(f/t),prostate specific antigen density(PSa D)= t PSa/PV(ml)).The observation group and the control group recorded the size of the prostate by transabdominal and transrectal ultrasound measurements with a probe in the abdomen.Observe whether there are nodules in the prostate,and record the size,location,border and internal echo of the nodules.All patients stopped using anticoagulants for one week before punctures and had an MRI exam on their prostates before punctures.The control group cleaned the intestines 1 hour before routine surgery and routinely took oral antibiotics for 3 days.Both groups of patients were punctured with knee-length sleeper and a 12-X-pin system puncture.All patients in the control group had systematic punctures and targeted punctures for suspected lesions.The final diagnosis is pathologically diagnosed after prostate surgery.The success rate of puncture,biopsy accuracy,number of positive needles,biopsy time and target puncture positive rate were recorded in both groups.SPSS 20.0 software was used to analyze the puncture success rate,biopsy accuracy,positive needle rate,biopsy time and target puncture positive rate,and compared the differences between the two groups of indicators.Result1.There was no statistically significant difference between the two groups of patients in age,t PSa,f/t,PSa D,and prostate volume.2.Tissues were obtained after puncture in both groups,and the puncture success rate was 100%;the positive rate of targeted puncture in the observation group and the control group was 36.4%(4/11)and 84.8%(39/46),the difference was statistically significant;The difference in biopsy time was statistically significant.There was no statistically significant difference in the puncture success rate,biopsy accuracy rate,and the number of positive needles between the two groups3.Some patients have different degrees of perineal swelling and pain,hematuria,fever,sepsis and acute urinary retention after puncture.Patients in the observation group with perineal pain,swelling,and hematuria were treated symptomatically after surgery,and all were relieved within 3 days.In the control group,all patients with urinary retention could urinate spontaneously and remove the catheter within 5 days after surgery;patients with fever and sepsis were cured after timely anti-infection.Conclusion1.The accuracy of needle biopsy using abdominal probe-guided transperineal prostate biopsy is not much different from transrectal prostate biopsy,and the complications are relatively mild and controllable.For special patients with suspected PCa and severe hemorrhoids,anal fissures,anal stenosis,or lower rectal tumors after surgery,in order to confirm the diagnosis of PCa,the application of transperineal prostate biopsy guided by abdominal probe is an effective operation technique.2.There are many methods of prostate biopsy with different advantages,and the rise and advantages of new technologies and multimodal imaging have pointed out the research direction and road for the in-depth study of prostate biopsy of this kind of patients.