Infectious complications after transrectal MRI-targeted and systematic prostate biopsy

Area of Science:

• Urology
• Infectious Disease
• Medical Imaging

Background:

• Prostate biopsy is crucial for diagnosing prostate cancer.
• Transrectal systematic biopsy (SB) and MRI-targeted biopsy (TB) are common methods.
• Infectious complications are a concern following prostate biopsies.

Purpose of the Study:

• To compare infectious complications between SB and MRI-TB.
• To determine if one biopsy technique is superior in preventing infections.
• To evaluate rates of positive cultures and inflammatory markers post-biopsy.

Main Methods:

• Retrospective analysis of 5288 prostate biopsies (2875 SB, 2413 MRI-TB).
• Infection-related complications within 30 days were assessed.
• Primary endpoint: positive urine culture; secondary: positive blood cultures, elevated leukocytes, elevated C-reactive protein (CRP).

Main Results:

• MRI-TB had significantly lower rates of positive urine cultures (1.7% vs 2.7%) and elevated leukocytes (2.5% vs 3.9%).
• Elevated CRP levels were also lower after MRI-TB (3.0% vs 4.2%).
• Blood culture positive infections were similarly rare for both methods (0.9% vs 1.0%).

Conclusions:

• MRI-targeted biopsy is associated with fewer infectious complications than transrectal systematic biopsy.
• The incidence of blood culture positive infections is comparable between SB and MRI-TB.
• Urology practices may consider MRI-TB to mitigate infectious risks.