Morbidity Of Prostate Biopsy After Simplified Versus Complex Preparation Protocols: Assessment of Risk Factors

Urology, 03/25/2011

Zaytoun OM et al. - This study demonstrates that a single antibiotic dose before prostate biopsy may be sufficient. Use of prebiopsy enemas is unnecessary to decrease overall complication rates.

Methods

  • 1438 transrectal ultrasound (TRUS)-guided prostate biopsies between January 2001 and June 2008 were retrospectively evaluated.
  • In group A, 931 men had only one dose of a quinolone antibiotic immediately before the procedure, and no enema was performed.
  • In group B, 507 men who underwent a prebiopsy enema and were given oral antibiotics starting the day before the procedure for 3 days.
  • Demographics and biopsy complications between the 2 groups were analysed.

Results

  • The overall complication rates were categorized as infection (2.2%), urine retention (0.8%), hematuria (4.4%), rectal bleeding (1.5%), sepsis (0.2%).
  • There was no significant statistical difference in the incidence of infection or sepsis between the 2 groups (2.7% vs 1.4%, P = .157 and 0.1% vs 0.4%, P = .285 respectively, for group A vs B).
  • Both hematuria and hematospermia were more common in group B (2.5% vs 7.9%, P < .001 and 0.2% vs 2%, P < .001 respectively, for group A vs B).
  • Prostate size was a significant risk for both hematuria (odds ratio = 1.7, 95% confidence interval = 1.2-2.44, P = .003) and acute urinary retention (odds ratio = 4.45, 95% confidence interval = 2.01-9.84, P < .001).

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