Abstract
The aim of this study was to assess infectious complications in transrectal ultrasound-guided prostate biopsy (TRUSPB), comparing two groups of patients: one group with antibiotic prophylaxis and the other without prophylaxis. A total of 1,018 TRUSPBs were performed from April 1996 to July 2003. No antibiotic prophylaxis was given in the first 614; the remaining 404 procedures were performed under antibiotic prophylaxis. Biopsy complications were assessed at outpatient urologist visits after the procedure in the 212 first biopsies and by telephone interview in the remaining 806. A total of 78 infectious complications were found. Major infectious complications (n=41) were septic shock (n=3), sepsis (n=3), Fournier gangrene (n=1), urinary tract infection (n=2), and fever requiring hospital admission (n=32). Minor infectious complications were fever that did not require admission (n=29), prostatitis (n=6), and epididymitis (n=2). Infectious complications occurred in 63 of 614 (10.3%) procedures without antibiotic prophylaxis and in 15 of 404 (3.7%) of those with antibiotic prophylaxis (P=0.0001). Of the 41 major infectious complications, 31 (75.6%) occurred in procedures without antibiotic prophylaxis (n=583) versus ten (24.4%) in those with prophylaxis (n=394) (P=0.0410). In conclusion, transrectal ultrasound-guided biopsy of the prostate has a statistically significant higher risk of infectious complications when performed without antibiotic prophylaxis.
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References
Shandera KC, Thibault GP, Deshon GE (1998). Variability in patient preparation for prostate biopsy among American urologists. Urology 52:644–646
Kapoor DA, Klimberg IW, Malek GH, Wegenke JD, Cox CE, Patterson AL, Graham E, Echols RM, Whalen E, Kowalsky SF (1998) Single-dose oral ciprofloxacin versus placebo for prophylaxis during transrectal prostate biopsy. Urology 52:552–558
Aron M, Rajeev TP, Gupta NP (2000) Antibiotic prophylaxis for transrectal needle biopsy of the prostate: a randomized controlled study. BJU Int 85:682–685
Ruebush TK, McConville JH, Calia FM (1979) A double-blind study of trimethoprim-sulfamethoxazole prophylaxis in patients having transrectal needle biopsy of the prostate. J Urol 122:492–494
Puig J, Serrate G, Donoso Ll, Falcó J, Sanchez L, Prera A (2000) Transrectal ultrasound-guided biopsy combined with local disinfection and double condom. Radiología 42:249–251
Harris LF, Jackson RT, Breslin JA, Alford RH (1978) Anaerobic septicemia after transrectal prostatic biopsy. Arch Intern Med 138:393–395
Breslin JA, Turner BI, Faber RB, Rhamy RK (1978) Anaerobic infection as a consequence of transrectal prostatic biopsy. J Urol 120:502–503
Ashby EC, Rees M, Dowding CH (1978) Prophylaxis against systemic infection after transrectal biopsy for suspected prostatic carcinoma. Br Med J 2:1263–1264
Thomson PM, Talbot RW, Packhamand DA, Dulake C (1980) Transrectal biopsy of the prostate and bacteraemia. Br J Surg 67:127–128
Melekos MD (1990) Efficacy of prophylactic antimicrobial regimens in preventing infectious complications after transrectal biopsy of the prostate. Int Urol Nephrol 22:257–262
Rees M, Ashby EC, Pocock RD, Dowding CH (1980) Povidone-iodine antisepsis for transrectal prostatic biopsy. BMJ 281:650
Sharpe JR, Sadlowsky RW, Finney RP, Branch WT, Hanna JE (1982). Urinary tract infection after transrectal needle biopsy of the prostate. J Urol 127:255–256
Richter S, Maayan MC, Nissenkornl I (1992) Safety of transrectal prostatic biopsy through double-glove technique without antibiotic prophylaxis. Urology 39:512–514
Fong IW, Struthers N, Honey RJ, Simbul M, Boisseau DA (1991) A randomized comparative study of the prophylactic use of trimethoprim-sulfamethoxazole versus netilmycin-metronidazole in transrectal prostatic biopsy. J Urol 146:794–797
Vallancien G, Prapotnich D, Veillon B, Brisset JM, Andre-Bougaran J (1991). Systematic prostatic biopsies in 100 men with no suspicion of cancer on digital rectal examination. J Urol 146:1308–1312
Aus G, Hermasson CG, Hugosson J, Pedersen KV (1993) Transrectal ultrasound examination of the prostate: complications and acceptance by patients. Br J Urol 71:457–459
Aus G, Ahlgren G, Bergdahl S, Hugosson J (1996) Infection after transrectal core biopsies of the prostate-risk factors and antibiotic prophylaxis. Br J Urol 77:851–855
Hammerer P, Huland H (1994). Systematic sextant biopsies in 651 patients referred for prostate evaluation. J Urol 151:99–102
Enlund AL, Varenhost E (1997) Morbidity of ultrasound-guided transrectal core biopsy of the prostate without prophylactic antiobiotic therapy. Br J Urol 79:777–780
Taylor HM, Bingham JB (1997) The use of prophylactic antibiotics in ultrasound-guided transrectal prostate biopsy. Clin Radiol 52:787–790
Davis M, Sofer M, Kim SS, Soloway MS (2002) The procedure of transrectal ultrasound guided biopsy of the prostate: a survey of patient preparation and biopsy technique. J Urol 167:566–570
Acknowledgements
The authors thank Lourdes Sanchez and Inés Artacho for their contribution in the clinical care of patients undergoing TRUSPB and John Giba for reviewing the English manuscript.
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Puig, J., Darnell, A., Bermúdez, P. et al. Transrectal ultrasound-guided prostate biopsy: is antibiotic prophylaxis necessary?. Eur Radiol 16, 939–943 (2006). https://doi.org/10.1007/s00330-005-0076-2
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DOI: https://doi.org/10.1007/s00330-005-0076-2