Risk factors associated with transrectal ultrasound guided prostate needle biopsy in patients with prostate cancer

Transrectal ultrasound (TRUS) guided prostate needle biopsy is a commonly used diagnostic procedure. We determined associated risk factors for patients who suffered major complications and required hospitalization after TRUS-guided prostate biopsy.

A total of 1,529 patients, 27 to 92 years old (mean 67.6 years) were included in this study conducted between January 2003 and July 2006. Each patient underwent sextant prostate biopsy under transrectal ultrasound guidance. Six-core transrectal biopsies were performed by urologists, consultant urologists and residents in training.

The mean prostate-specific antigen (PSA) level and prostate volume were 113.2 ng/ml and 46.2 grams, respectively. One hundred forty-seven patients had complications. Some patients may have had more than one complication, but no major sequelae were seen immediately after biopsy. Sixty-two (4.1%) of these patients had gross hematuria, while 26 (1.7%) had acute urinary retention, 21 (1.4%) had urinary tract infection, 17 (1.1%) had hematospermia,14 (0.9%) had anal bleeding and 7 (0.5%) had anal pain. Urinary tract infection and rectal preparation were found significantly associated with complications.

The results of our study demonstrate that minor complications occur without sequelae. Thus, TRUS-guided prostate needle biopsy is a safe and effective diagnostic tool. Urinary tract infection and rectal preparation might affect the complication rate.