title: The impact of prostate biopsy on patient well-being: a prospective study of voiding impairment.
abstract: OBJECTIVE
  We studied the possible association of transrectal ultrasound guided prostate biopsy with voiding impairment.
  
  
  METHODS
  A total of 211 consecutive patients were prospectively enrolled. International Prostate Symptom Score (I-PSS), subjective voiding complaints and retention were recorded in 3 personal interviews before biopsy, and on postoperative days 7 and 30.
  
  
  RESULTS
  Of the 204 patients who voided via the urethra at biopsy 52 (25%) reported subjective voiding impairment on postoperative day 7, including 12% who defined difficult voiding as mild-1 to 2 points on a 0 to 5 scale, 8% as moderate-3/5 and 5% as severe-4 to 5/5. In 5 of the latter cases (2.5%) acute urinary retention necessitated urethral catheter insertion. Transition zone volume, which was 42 ml. or larger in all patients in urinary retention, was the only independent variable associated with patient report of subjective difficult voiding and acute urinary retention during week 1 after biopsy (p = 0.03). Baseline I-PSS greater than 20 points indicated a risk of an acute transient increase in I-PSS on postoperative day 7.
  
  
  CONCLUSIONS
  Transient voiding impairment may be precipitated by ultrasound guided prostate biopsy. To decrease this morbidity appropriate evaluation and possible treatment for bladder outlet obstruction are justified in patients with a larger transition zone and in those with preoperative baseline I-PSS greater than 20 points.
authors.affiliation: Department of Urology, Assaf-Harofeh Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Zerifin, Israel.
authors.forename: A
authors.initials: A
authors.lastname: Zisman
authors.forename: D
authors.initials: D
authors.lastname: Leibovici
authors.forename: J
authors.initials: J
authors.lastname: Kleinmann
authors.forename: A
authors.initials: A
authors.lastname: Cooper
authors.forename: Y
authors.initials: Y
authors.lastname: Siegel
authors.forename: A
authors.initials: A
authors.lastname: Lindner
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000473:pathology*; D011788:Quality of Life; D012720:Severity of Illness Index; D016055:Urinary Retention / Q000453:epidemiology / Q000209:etiology*