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Niger J Clin Pract ; 23(9): 1183-1187, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32913154


Aims: This study compared the analgesic effect of apical peri-prostatic block with that of intra-rectal xylocaine gel for trans-rectal ultrasound guided prostate biopsy (TRUS-PBx) in Nigeria. Methods: This is a prospective randomized comparative study carried out over one year in University of Benin Teaching Hospital, Edo State, Nigeria. The participants were randomized into two groups; Group A had 10 mls of intra-rectal xylocaine gel instillation while Group B had apical infiltration of 10 mls of 1% xylocaine all before TRUS-PBx. Result: There was a statistically significant difference in the mean pain score during and one hour after TRUS-PBx between Group A and Group B of the study population respectively (p < 0.0001). Those that had intra-rectal xylocaine gel (Group A) had more pain during and after biopsy. There was no difference in the mean pain score during probe insertion between the two groups (p = 0.952). Conclusion: This study demonstrated the superiority of apical peri-prostatic nerve block over intra rectal xylocaine gel instillation during TRUS-PBx with respect to its anesthetic efficacy. Therefore, centers providing TRUS-PBx in Nigeria should consider apical peri-prostatic nerve block as their mode of anesthesia for the procedure due to its efficacy and high safety profile.

Biópsia por Agulha/métodos , Biópsia Guiada por Imagem/métodos , Lidocaína/administração & dosagem , Bloqueio Nervoso/métodos , Dor/prevenção & controle , Próstata/patologia , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/patologia , Administração Retal , Idoso , Anestésicos Locais/administração & dosagem , Biópsia por Agulha/efeitos adversos , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria , Dor/etiologia , Medição da Dor , Estudos Prospectivos , Próstata/diagnóstico por imagem , Próstata/inervação , Reto/patologia , Ultrassonografia de Intervenção
West Afr J Med ; 37(2): 159-172, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32150635


BACKGROUND AND OBJECTIVES: The purpose is to update the consensus statements on management of prostate cancer in West Africa. In 2010, "Prostate Cancer: Guidelines for diagnosis and treatment in West Africa" was first published. Since then, there have been several developments in diagnosis and management of prostate cancer. These need to be incorporated to produce a 2019 update. The aspiration is that it will serve as a benchmark for the basic standard of care for patients with prostate cancer in West Africa or even as a working document for the development of guidelines for treatment of prostate cancer by urological associations, other professional societies, institutions or government. METHODS: A search of the literature was performed to identify recent studies. Those of relevance to West Africa, were extracted for evaluation to enable update of the recommendations. RESULTS: There are three themes (screening/diagnosis, clinical pathology, treatment) with 20 guideline topics covering screening, diagnosis, staging, grading, classification and management. New evidence in screening, definition of normal prostate-specific antigen, and use of pre-biopsy magnetic resonance imaging, have been incorporated. CONCLUSION: This update will serve as a benchmark to assist clinicians in achieving best practice in the management of prostate cancer. It should also serve as a trigger for audits and research towards improving access to effective diagnosis and treatment of prostate cancer in West Africa.

Guias de Prática Clínica como Assunto , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/terapia , África Ocidental , Biópsia , Consenso , Humanos , Imagem por Ressonância Magnética , Masculino , Neoplasias da Próstata/patologia