[Transrectal prostate biopsy: effective anesthesia, complications, and influence on clinical outcome after radical...

The aim of the study was to evaluate the best anesthesia for transrectal prostate biopsy, the complications after biopsy, and the influence of the biopsy on the clinical outcome after radical prostatectomy. The analysis included 1,383 patients after radical prostatectomy. With respect to compliance the biopsy should be performed under anesthesia. The most efficient procedure for pain reduction is analgosedation. Periprostatic local anesthetic in combination with the application of a lidocaine-containing jelly is in alternative use. Antibiotic prophylaxis should be given in consideration of possible antibiotic resistance due to recently administered antibiotic therapy. The percentage of R1 resection is higher if only one prostate biopsy can detect the carcinoma and leads immediately to radical prostatectomy. When several biopsies are necessary to detect the carcinoma the percentage of R1 resection is lower. Repeated prostate biopsies have no effect on the patients' outcome after radical prostatectomy. The best time for radical prostatectomy in relation to urinary incontinence is 8 weeks after prostate biopsy.