The Severity of Pain in Prostate Biopsy Depends on the Biopsy Sector.

BACKGROUND: The pain experienced by a patient during a prostate fusion biopsy is cumulative and can also be modulated by many factors. The aim of the study was to assess the association between the degree of pain intensity during prostate biopsy and the region of the biopted organ. MATERIALS AND METHODS: The study included a group of 143 patients who underwent prostate fusion biopsy under local analgesia followed by blockage of the periprostatic nerve. After a biopsy, the patients completed the original questionnaire about the pain experienced during the procedure. RESULTS: There was a statistically significant difference in pain score between cores taken in the apex (median 5 (IQR 2-5)), medium level (median 1 (IQR 1-2)), and prostate base (median 1 (IQR 1-3)) (p < 0.001). The malignancy scale ISUP ≥ 2 (p = 0.038) and lower PSA value (r = -0.17; p = 0.046) are associated with higher pain during procedure. Biopsy time was correlated with discomfort (r = 0.19; p = 0.04). Age (p = 0.65), lesion size (p = 0.29), PI-RADS score (p = 0.86), prostate volume (p = 0.22), and the number of cores (p = 0.56) did not correspond to the pain scale. CONCLUSIONS: The apex is the most sensitive sector of the prostate. ISUP ≥ 2 and patients with low PSA levels more often indicated higher values on the pain rating scale.

The influence of the operator's experience on the outcomes of fusion prostate biopsy.

Introduction: Magnetic resonance imgaing (MRI) targeted biopsy is the gold standard for prostate cancer (PCa) diagnosis. In this study, we examined the association between the operator's experience and the improvement in the precision of the MRI prostate biopsy procedure and the detection of PCa. Material and methods: We included consecutive patients who underwent prostate fusion biopsy. Data on biopsy duration, prostate-specific antigen (PSA) value, lesion size, number of samples taken, number of cores involved, and International Society of Urological Pathology (ISUP) grade were subjected to statistical analysis, with the study group divided into three consecutive time periods (tertiles). Results: There were statistically significant differences in biopsy duration between tertiles (p <0.001). The greatest difference in the involved/taken cores ratio occurred between the first and third tertile (p = 0.002). The difference between the first and second tertile was insignificant (p = 0.4), while the difference between the second and third tertile was statistically significant (p = 0.004). The differences between tertiles in Prostate Imaging and Reporting Data System v2.1 were also significant (p = 0.003). The PSA value (p = 0.036) was statistically significant, unlike prostate volume (p = 0.16), digital rectal examination (DRE) (p = 0.7), and ISUP grade (p = 0.7). There was no statistical difference between tested tertiles in the number of detected PCa ISUP ≥2 (Z = 0.191; p = 0.8). Conclusions: The abilities and precision of the operator increase with the increase in the number of procedures performed. The biopsy duration is shortened, and the detection of PCa during the procedure seems to improve with the operator's experience.

Awareness of testicular cancer among adult Polish men and their tendency for prophylactic self-examination: conclusions from Movember 2020 event.

BACKGROUND: Testicular cancer (TC), due to its non-specific symptoms and occurrence in young men, is particularly dangerous. A critical point for early diagnosis is awareness of the disease and the willingness to perform a testicular self-examination (TSE). The main aim of the study was to assess the knowledge of 771 adult men about testicular cancer. Additionally, the sources of information on TC and TSE were analyzed and the influence of demographic factors on the willingness to join preventative programs was examined. MATERIALS AND METHODS: The study was carried out during the Movember2020 campaign, where a testicular ultrasound was performed on participants. They were asked to complete a questionnaire with 26 questions to assess their knowledge. RESULTS: The results obtained in the study indicate a low level of knowledge (average 3.5 points out of 18) about TC. Living in a large city (OR = 1.467; p = 0.03), as well as an earlier conversation about TC (OR = 1.639; p = 0.002), increased the awareness about the disease. Additionally it showed that many participants do not perform TSE at all (52.4%) and that only few perform TSE frequently (18.4%). Relationship status (OR = 2.832; p < 0.001) and previous conversations about TC (OR = 1.546; p = 0.02) was reported to be the main contributing factors in males deciding to have TSE. CONCLUSIONS: Our research indicates large educational neglect in terms of knowledge about TC and reluctance in performing TSE. It is worth carrying out preventative actions periodically on an increasing scale, not only for the screening of testicular cancer, but also to expand knowledge on this subject.

Online Crowdfunding for Urologic Cancer Care.

Background: we aimed to characterize the financial needs expressed through online crowdfunding for urologic cancers. Methods: the data used in this study came from the online crowdfunding platform GoFundMe.com. Using an automated software method, we extracted data for campaigns related to urologic cancers. Subsequently, four independent investigators reviewed all extracted data on prostate, bladder, kidney and testicular cancer. We analyzed campaigns' basic characteristics, goals, fundraising, type of treatment and factors associated with successful campaigns. Results: in total, we identified 2126 individual campaigns, which were related to direct treatment costs (34%), living expenses (17%) or both (48%). Median fundraising amounts were greatest for testicular cancer. Campaigns for both complementary and alternative medicine (CAM) (median $11,000) or CAM alone (median $8527) achieved higher fundraising totals compared with those for conventional treatments alone (median $5362) (p < 0.01). The number of social media shares was independently associated with campaign success and highest quartile of fundraising. Conclusions: using an automated web-based approach, we identified and characterized online crowdfunding for urologic cancer care. These findings indicated a diverse range of patient needs related to urologic care and factors related to campaigns' success.