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Complications following combined transrectal aspiration and core biopsy of the prostate
O Gustafsson1, U Norming, C R Nyman
1Department of Urology, Södersjukhuset, Stockholm.
Abstract:
Ultrasound guided biopsy of the prostate with fine needle (22G) as well as trucut needle (18G) was performed in 145 patients with a suspicion of prostate cancer. After three weeks all patients were interviewed about complications associated with the biopsy. Hematuria and/or hemospermia occurred in 2/3 of the patients. None of the hemorrhages was severe and all ceased spontaneously. E. coli infection of the urinary tract occurred in 9 cases (6.2%). Five of the infections caused high fever and necessitated hospital care with parenteral antibiotics for 1 to 8 days. The patients with infection had no signs of immunological defects by which they might have been identified before the biopsy. As a consequence of these observations we now use prophylactic antibiotics when core biopsy of the prostate is performed transrectally.
Insights
Prostate biopsies can cause bleeding and E. coli infections. Prophylactic antibiotics are now recommended for transrectal prostate core biopsies to prevent infection.
Area of Science:
- Urology
- Oncology
- Infectious Diseases
Background:
- Prostate cancer diagnosis often involves ultrasound-guided biopsy.
- Complications such as hematuria, hemospermia, and infection can occur post-biopsy.
Purpose of the Study:
- To evaluate the complications of ultrasound-guided prostate biopsy using fine needle (22G) and trucut needle (18G).
- To assess the incidence and severity of post-biopsy complications, including bleeding and urinary tract infections.
Main Methods:
- 145 patients with suspected prostate cancer underwent ultrasound-guided prostate biopsy.
- Patients were interviewed three weeks post-biopsy to document complications.
- Complications analyzed included hematuria, hemospermia, and urinary tract infections (UTIs).
Main Results:
- Hematuria and/or hemospermia were reported in two-thirds of patients, with all hemorrhages resolving spontaneously.
- Escherichia coli (E. coli) urinary tract infections occurred in 9 patients (6.2%).
- Five patients (3.5%) experienced severe infections requiring hospitalization and parenteral antibiotics.
Conclusions:
- Transrectal ultrasound-guided prostate biopsy is associated with a significant risk of bleeding and infectious complications.
- Prophylactic antibiotic use is now implemented for transrectal prostate core biopsies due to observed infection rates.
- Further research may be needed to optimize antibiotic prophylaxis protocols.