ABSTRACT
We aimed to determine short-term patient-reported outcomes in men having general anesthetic transperineal (TP) prostate biopsies. A prospective cohort study was performed in men having a diagnostic TP biopsy. This was done using a validated and adapted questionnaire immediately post-biopsy and at follow-up of between 7 and 14 days across three tertiary referral hospitals with a response rate of 51.6%. Immediately after biopsy 43/201 (21.4%) of men felt light-headed, syncopal, or suffered syncope. Fifty-three percent of men felt discomfort after biopsy (with 95% scoring <5 in a 0-10 scale). Twelve out of 196 men (6.1%) felt pain immediately after the procedure. Despite a high incidence of symptoms (e.g., up to 75% had some hematuria, 47% suffered some pain), it was not a moderate or serious problem for most, apart from hemoejaculate which 31 men suffered. Eleven men needed catheterization (5.5%). There were no inpatient admissions due to complications (hematuria, sepsis). On repeat questioning at a later time point, only 25/199 (12.6%) of men said repeat biopsy would be a significant problem despite a significant and marked reduction in erectile function after the procedure. From this study, we conclude that TP biopsy is well tolerated with similar side effect profiles and attitudes of men to repeat biopsy to men having TRUS biopsies. These data allow informed counseling of men prior to TP biopsy and a benchmark for tolerability with local anesthetic TP biopsies being developed for clinical use.
Subject(s)
Anesthesia, Local , Attitude to Health , Biopsy, Large-Core Needle/methods , Perineum/surgery , Postoperative Complications/epidemiology , Prostate/pathology , Prostatic Neoplasms/pathology , Aged , Cohort Studies , Dizziness/epidemiology , Hematuria/epidemiology , Humans , Male , Middle Aged , Pain, Postoperative/epidemiology , Patient Reported Outcome Measures , Prospective Studies , Surveys and Questionnaires , Syncope/epidemiologyABSTRACT
We consider quantum Hall states at even-denominator filling fractions, especially nu=5/2, in the limit of small Zeeman energy. Assuming that a paired quantum Hall state forms, we study spin ordering and its interplay with pairing. We give numerical evidence that at nu=5/2 an incompressible ground state will exhibit spontaneous ferromagnetism. The Ginzburg-Landau (GL) theory for the spin degrees of freedom of paired Hall states is a perturbed CP2 model. We compute the coefficients in the GL theory by a BCS Stoner mean-field theory for coexisting order parameters, and show that even if repulsion is smaller than that required for a Stoner instability, ferromagnetic fluctuations can induce a partially or fully polarized superconducting state.
