The global burden of major infectious complications following prostate biopsy

Area of Science:

• Urology
• Infectious Diseases
• Public Health

Background:

• Prostate biopsy is a common procedure for diagnosing prostate cancer.
• Infectious complications following prostate biopsy can lead to significant morbidity.
• Understanding the burden and variations in these complications is crucial for patient care.

Purpose of the Study:

• To systematically review and estimate the overall and regional burden of infectious complications after prostate biopsy.
• To compare complication rates between transrectal and transperineal biopsy techniques.
• To identify regional variations in complication rates.

Main Methods:

• Systematic review of 165 articles including 162,577 patients.
• Directly standardized prevalence estimates were used to assess disease burden.
• Complications analyzed included sepsis, hospitalization, bacteraemia, bacteriuria, and acute urinary retention.

Main Results:

• Transrectal biopsy showed higher rates of hospitalization (1.1% vs. 0.9%) and sepsis (0.8% vs. 0.1%) compared to transperineal biopsy.
• Transperineal biopsy was associated with higher rates of acute urinary retention (4.2% vs. 0.9%).
• Statistically non-significant differences were observed due to significant heterogeneity; Asian studies reported higher sepsis and hospitalization rates.

Conclusions:

• Both transrectal and transperineal prostate biopsies carry risks of infectious complications.
• Regional variations in complication rates exist, necessitating further investigation into contributing factors.
• Optimizing biopsy techniques and patient management strategies can help mitigate complication risks.