Lateral decubitus position vs. lithotomy position: which is the best way to minimize patient’s pain perception during transrectal prostate biopsy?

Objective: Prostate cancer is the fourth most common malignancy in men. TRUS guided transperineal prostate biopsy and TRUS guided transrectal prostate biopsy are two main approach to take prostate tissue as diagnostic of prostate cancer. To compare prostate biopsy approach between TRUS guided transrectal and TRUS guided transperineal toward duration of examination, pain perception, and complications. Material & Method: This study was an experimental study with prospective approach. There were two groups, group one was performed TRUS guided transrectal prostate biopsy (TRB) and group two was performed TRUS guided transperineal prostate biopsy (TPB). Evaluation was based on the duration of examination, pain perception, and complication. Data was analyzed using independent T test for duration of examination and Mann-Whitney test for pain perception. Data was performed using SPSS 21.0 version. The statistical significant difference was consider if p value <0.05. Results: There were 20 samples in this study. There was a significant difference in the duration of examination, the average duration of TPB examination (17.40 ± 2.50) was longer than the duration of TRB examination (14.1 ± 2.77). There was no significant statistical difference between TPB group and TRB group in pain perception when USG probe into the anal (p=0.65), anesthesia process (p=0.28), prostate tissue sampling (p=1.00), and post biopsy (p=0.34). Rectal bleeding was found mostly in TRB group (40%) compared to TPB group (0%). Hematuria was experienced by three patients (30%) in TRB group and two patients (20%) in TPB group. Conclusion: TRB was more effective in duration of biopsy than TPB. The complications of rectal bleeding and hematuria were more in TRB group than TPB. The pain perception were the same between both groups. There were no fever, sepsis, hematospermia and vasovagal event in two groups.

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Lateral Decubitus Position to Facilitate Pelvic Examination of the Patient with Severe Obesity

10.21203/rs.3.rs-116787/v1 ◽

2020 ◽

Author(s):

Daniel M. Breitkopf

Keyword(s):

Severe Obesity ◽

Outpatient Setting ◽

Lateral Decubitus Position ◽

Lithotomy Position ◽

Pelvic Examination ◽

Pelvic Exam ◽

Institutional Review ◽

Lateral Decubitus ◽

Dorsal Lithotomy Position ◽

Dorsal Lithotomy

Abstract Background: Patients with elevated BMI pose a number of challenges for the gynecologist. Pelvic examination may be more difficult due to adiposity in the perineum and labia, increasing the distance between the vulva and cervix. The objective of the current work was to describe use of the lateral decubitus position to improve visualization of the cervix in women with severe obesity. Methods: From 7/1/2010 until 1/31/2020, all records of patients with obesity and unsuccessful cervical visualization during pelvic exam in the dorsal lithotomy position in the author’s clinical practice were reviewed after obtaining Mayo Clinic Institutional Review Board approval. For the lateral decubitus position, the patient was asked to lie on her side on the exam table, facing away from the examiner with knees bent. An assistant elevated the upper bent leg 45 degrees from horizontal, exposing the perineum. A vaginal speculum was then placed in the vagina with the posterior blade toward the anus. The speculum was opened gently as would be done with examination in dorsal lithotomy position until the cervix was visualized.Results: Eleven patients with severe obesity in the gynecologic practice of the author with prior unsuccessful cervical visualization in dorsal lithotomy position were examined in the lateral decubitus position. In all but one case the cervix was successfully visualized in the lateral decubitus position and all intended intrauterine procedures were successfully performed. Conclusions: The use of the lateral decubitus position appears to improve visualization of the cervix in the outpatient setting among women with severe obesity. Consideration should be given to use of the lateral decubitus position when the cervix cannot be visualized in the dorsal lithotomy position.Trial registration: not applicable

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Lateral decubitus position to facilitate pelvic examination of the patient with severe obesity

BMC Women s Health ◽

10.1186/s12905-021-01289-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Daniel M. Breitkopf

Keyword(s):

Severe Obesity ◽

Case Series ◽

Outpatient Setting ◽

Lateral Decubitus Position ◽

Lithotomy Position ◽

Pelvic Examination ◽

Institutional Review ◽

Lateral Decubitus ◽

Dorsal Lithotomy Position ◽

Dorsal Lithotomy

Abstract Background Patients with elevated BMI pose a number of challenges for the gynecologist. Pelvic examination may be more difficult due to adiposity in the perineum and labia, increasing the distance between the vulva and cervix. The objective of the current work was to describe use of the lateral decubitus position to improve visualization of the cervix in women with severe obesity. Methods A case series was collected. From 7/1/2010 until 1/31/2020, all records of patients with obesity and unsuccessful cervical visualization during pelvic exam in the dorsal lithotomy position in the author’s clinical practice were reviewed after obtaining Mayo Clinic Institutional Review Board approval. For the lateral decubitus position, the patient was asked to lie on her side on the exam table, facing away from the examiner with knees bent. An assistant elevated the upper bent leg 45 degrees from horizontal, exposing the perineum. A vaginal speculum was then placed in the vagina with the posterior blade toward the anus. The speculum was opened gently as would be done with examination in dorsal lithotomy position until the cervix was visualized. Results Eleven patients with severe obesity in the gynecologic practice of the author with prior unsuccessful cervical visualization in dorsal lithotomy position were examined in the lateral decubitus position. In all but one case the cervix was successfully visualized in the lateral decubitus position and all intended intrauterine procedures were successfully performed. Conclusions In this case series, the use of the lateral decubitus position appears to improve visualization of the cervix in the outpatient setting among women with severe obesity. Consideration should be given to use of the lateral decubitus position when the cervix cannot be visualized in the dorsal lithotomy position.

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Surgical Techniques for Thoracoscopic Esophagectomy at the Left Lateral Decubitus Position

Nihon Kikan Shokudoka Gakkai Kaiho ◽

10.2468/jbes.70.197 ◽

2019 ◽

Vol 70 (2) ◽

pp. 197-197

Author(s):

H. Sato ◽

Y. Miyawaki ◽

N. Fujiwara ◽

H. Sugita ◽

M. Aikawa ◽

...

Keyword(s):

Surgical Techniques ◽

Lateral Decubitus Position ◽

Thoracoscopic Esophagectomy ◽

Left Lateral Decubitus Position ◽

Lateral Decubitus

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Efficiency of I-gel Supraglottic Airway Device in Supine and Lateral Decubitus Position in Obese Patient

Case Medical Research ◽

10.31525/ct1-nct04119245 ◽

2019 ◽

Author(s):

Keyword(s):

Obese Patient ◽

Airway Device ◽

Lateral Decubitus Position ◽

Supraglottic Airway ◽

Supraglottic Airway Device ◽

Lateral Decubitus

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Faculty Opinions recommendation of Asymmetric postoperative visual loss after spine surgery in the lateral decubitus position.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1119513.575719 ◽

2008 ◽

Author(s):

Gary Mills

Keyword(s):

Spine Surgery ◽

Visual Loss ◽

Lateral Decubitus Position ◽

Lateral Decubitus ◽

Postoperative Visual Loss

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Changes in the Bronchial Cuff Pressure of Left-Sided Double-Lumen Endotracheal Tube by Lateral Positioning: A Prospective Observational Study

Journal of Clinical Medicine ◽

10.3390/jcm10081590 ◽

2021 ◽

Vol 10 (8) ◽

pp. 1590

Author(s):

Jong-Hae Kim ◽

Eugene Kim ◽

In-Young Kim ◽

Eun-Joo Choi ◽

Sung-Hye Byun

Keyword(s):

Thoracic Surgery ◽

Endotracheal Tube ◽

Primary Outcome ◽

Cuff Pressure ◽

Lateral Decubitus Position ◽

Double Lumen ◽

Double Lumen Endotracheal Tube ◽

Bronchial Cuff ◽

Lateral Decubitus ◽

Lateral Positioning

Proper bronchial cuff pressure (BCP) is important when using a double-lumen endotracheal tube (DLT), especially in thoracic surgery. As positional change during endotracheal tube placement could alter cuff pressure, we aim to evaluate the change in BCP of DLT from the supine to the lateral decubitus position during thoracic surgery. A total of 69 patients aged 18–70 years who underwent elective lung surgery were recruited. BCP was measured at a series of time points in the supine and lateral decubitus positions after confirming the DLT placement. The primary outcome was change in the initial established BCP (BCPi), which is the maximum pressure at which the BCP did not exceed 40 cmH2O without air leak in the supine position, after lateral decubitus positioning. As the primary outcome, the BCPi increased from 25.4 ± 9.0 cmH2O in the supine position to 29.1 ± 12.2 cmH2O in the lateral decubitus position (p < 0.001). Out of the 69 participants, 43 and 26 patients underwent surgery in the left-lateral decubitus position (LLD group) and the right-lateral decubitus position (RLD group) respectively. In the LLD group, the BCPi increased significantly (p < 0.001) after lateral positioning and the beginning of surgery and the difference value, ∆BCPi, from supine to lateral position was significantly higher in the LLD group than in the RLD group (p = 0.034). Positional change from supine to lateral decubitus could increase the BCPi of DLT and the increase was significantly greater in LLD that in RLD.

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