Epididymitis after transrectal ultrasound-guided needle biopsy of prostate gland

To evaluate the incidence, predisposing factors, and time-course of epididymitis after transrectal ultrasound-guided (TRUS) needle biopsy of the prostate gland.

A total of 739 consecutive patients underwent TRUS-guided biopsy of the prostate gland from January 2000 through December 2002 using a systematic approach, 18-gauge needles, and antibiotic prophylaxis. A median of 9 biopsies was obtained per patient (range 4 to 16). All cases of epididymitis occurring within 6 months of biopsy were attributed to the TRUS procedure. The parameters evaluated for epididymitis included patient age, prostate-specific antigen, prostate volume, prostate-specific antigen density, number of biopsies obtained, and number of biopsies positive for malignancy.

Five patients (0.7%) developed biopsy-related epididymitis with a median onset of 85 days (range 13 to 143) after biopsy. Patients developing epididymitis were statistically older, with a trend for a greater number of prostate biopsies (P = 0.071 on linear regression analysis). Only 1 patient developed epididymitis within 3 weeks of biopsy. All cases of epididymitis responded to therapeutic antibiotics.

Epididymitis after TRUS-guided biopsy is a relatively uncommon event, with an incidence of approximately 1% and an onset of weeks to months after the procedure. Patients who developed epididymitis were statistically older, with a trend for a greater number of prostate biopsies taken.