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Updated: May 29, 2026
Transperineal Prostate Biopsy Using a Cone-shaped Double-hole Method with Dual-plane Probe Guidance
Published on: June 6, 2025
Complications after prostate biopsy: data from SEER-Medicare
Stacy Loeb1, H Ballentine Carter, Sonja I Berndt
1Brady Urological Institute, The Johns Hopkins Medical Institutions, Baltimore, Maryland 21287, USA. stacyloeb@gmail.com
Purpose:
More than 1 million prostate biopsies are performed annually among Medicare beneficiaries. We determined the risk of serious complications requiring hospitalization. We hypothesized that with emerging multidrug resistant organisms there may be an increasing risk of infectious complications.
Materials And Methods:
In a 5% random sample of Medicare participants in SEER (Surveillance, Epidemiology and End Results) regions from 1991 to 2007 we compared 30-day hospitalization rates and ICD-9 primary diagnosis codes for admissions between 17,472 men who underwent prostate biopsy and a random sample of 134,977 controls. Multivariate logistic and Poisson regression were used to examine the risk and predictors of serious infectious and noninfectious complications with time.
Results:
The 30-day hospitalization rate was 6.9% within 30 days of prostate biopsy, which was substantially higher than the 2.7% in the control population. After adjusting for age, race, SEER region, year and comorbidities prostate biopsy was associated with a 2.65-fold (95% CI 2.47-2.84) increased risk of hospitalization within 30 days compared to the control population (p <0.0001). The risk of infectious complications requiring hospitalization after biopsy was significantly greater in more recent years (p(trend) = 0.001). Among men undergoing biopsy, later year, nonwhite race and higher comorbidity scores were significantly associated with an increased risk of infectious complications.
Conclusions:
The risk of hospitalization within 30 days of prostate biopsy was significantly higher than in a control population. Infectious complications after prostate biopsy have increased in recent years while the rate of serious noninfectious complications is relatively stable. Careful patient selection for prostate biopsy is essential to minimize the potential harms.
Insights
Prostate biopsies lead to a higher risk of hospitalization, especially for infectious complications, which are increasing. Patient selection is crucial to reduce potential harms from this common procedure.
Area of Science:
- Urology
- Public Health
- Infectious Diseases
Background:
- Over 1 million prostate biopsies are performed annually in the US on Medicare beneficiaries.
- The risk of serious complications requiring hospitalization following prostate biopsy is a significant concern.
- Emerging multidrug-resistant organisms may be contributing to an increased risk of infectious complications.
Purpose of the Study:
- To determine the risk of serious complications requiring hospitalization after prostate biopsy.
- To investigate the hypothesis that infectious complication risk is increasing due to multidrug-resistant organisms.
Main Methods:
- A 5% random sample of Medicare participants in SEER regions (1991-2007) was analyzed.
- Compared 30-day hospitalization rates and diagnosis codes between 17,472 men undergoing prostate biopsy and 134,977 controls.
- Used multivariate logistic and Poisson regression to assess risk and predictors of complications.
Main Results:
- The 30-day hospitalization rate post-prostate biopsy was 6.9%, significantly higher than the 2.7% in controls.
- Prostate biopsy was associated with a 2.65-fold increased risk of hospitalization (p <0.0001).
- The risk of infectious complications requiring hospitalization increased significantly in recent years (p(trend) = 0.001), associated with later year, nonwhite race, and higher comorbidity scores.
Conclusions:
- Hospitalization risk within 30 days of prostate biopsy is substantially elevated compared to a control group.
- Serious noninfectious complications remain stable, but infectious complications have risen.
- Careful patient selection is essential to mitigate the risks associated with prostate biopsy.
