ABSTRACT
OBJECTIVE: To evaluate patients' perception of pain and discomfort during DRE, the impact of discomfort on potential future screening compliance, and if emptying the bladder immediately before DRE reduces patient discomfort. METHODS: One-hundred patients undergoing DRE for prostate cancer screening answered an anonymous questionnaire regarding pain, urinary urgency and bowel urgency during DRE and its potential impact on future examination. Another group with 100 patients was randomized in two subgroups to analyze if urinating immediately before DRE reduces patient discomfort. RESULTS: Seventy-three (73%) patients reported moderate or higher discomfort for at least one of the domains evaluated: 61% complained of pain; 22% of urinary urgency; and 22% of bowel urgency. Emptying the bladder immediately before examination did not reduce pain (58% vs. 50%, p = 0.115), urinary urgency (22% vs. 16%, p = 0.151), or bowel urgency intensity (16% vs. 14%, p = 0.264). There was no difference in the number of patients that answered they will repeat the prostate exam next year (96% vs. 90%, p = 0.211) or in those that would encourage a friend that needs the prostate exam to do it (96% vs. 98%, p = 0.378). CONCLUSIONS: Pain and discomfort during DRE are not negligible but they do not affect intention to have a prostate exam in the future. Urinating immediately before examination does not significantly reduce the incidence of pain, urinary urgency, or bowel urgency during DRE.
Subject(s)
Digital Rectal Examination/adverse effects , Pain Measurement , Pain/etiology , Prostatic Neoplasms/diagnosis , Surveys and Questionnaires , Humans , Male , Mass Screening , UrinationABSTRACT
Ascaridiase é uma importante causa de doença pancreatico-biliar em paises endemicos. Relata-se o caso de um paciente de 68 anos, com queixa de epigastralgia, previamente colecistectomizado e submetido a derivacao biliodigestiva por litiase biliar sintomatica. Ao exame de endoscopia digestiva alta (EDA), identificou-se derivacao biliodigestiva (coléduco-duodenostomia) pérvia, contendo corpo estranho intraluminal (ascáris) no seu interior, que foi removido por via endoscopica com sucesso. O sintoma clinico mais importante nessa doenca é a dor abdominal; complicacoes como obstruçao parcial do trato biliar e colangite podem estar presentes. A ultra-sonografia, a tomografia computadorizada e a colangiopancreatografia endoscópica retrograda näo sao apenas importantes para o diagnostico dessa enfermidade, mas também sao uteis para orientar o melhor tratamento e o seu seguimento, Os procedimentos cirurgicos estäo sendo reservados para os casos complicados
