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Related Concept Videos

Urinary Tract Infection II: Pathophysiology01:25

Urinary Tract Infection II: Pathophysiology

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The pathophysiology of urinary tract infections (UTIs) encompasses several progressive stages, beginning with bacterial colonization and culminating in potential systemic complications if untreated. UTIs are primarily initiated by bacteria, such as Escherichia coli, which often originate from the gastrointestinal tract and migrate to the urinary system through the periurethral area. This migration can occur via several routes, including improper hygiene practices, sexual activity, or...
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Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications01:25

Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications

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Peritoneal dialysis (PD) is a medical process that removes waste products and excess fluid from the body using the peritoneal membrane as a natural filter.Peritoneal Dialysis MethodsSeveral methods can be used for peritoneal dialysis, including Acute Intermittent Peritoneal Dialysis, Continuous Ambulatory Peritoneal Dialysis, and Automated Peritoneal Dialysis, also known as Continuous Cyclic Peritoneal Dialysis.Acute Intermittent Peritoneal Dialysis (AIPD) is used for patients with uremic...
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Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care01:30

Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care

38
A healthcare provider can diagnose a urinary tract infection (UTI) through several methods:Medical History and Symptoms: The provider will take a detailed medical history and ask about symptoms such as frequent urination, burning sensation during urination, and lower abdominal pain.Urinalysis: A clean-catch urine sample is collected in a sterile container and tested for the presence of bacteria, white blood cells (leukocytes), nitrites, blood, and protein. The presence of leukocytes and...
38
Urinary Tract Infection I: Introduction01:26

Urinary Tract Infection I: Introduction

50
Urinary tract infections (UTIs) impact various parts of the urinary system, including the kidneys, ureters, bladder, and urethra. These infections are generally bacterial, with Escherichia coli being the most common causative agent, often originating from the gastrointestinal tract. However, other bacteria, such as Staphylococcus saprophyticus, Klebsiella pneumoniae, and Proteus mirabilis, are also known to cause UTIs. The type, location, and underlying complexity of the UTI guide both...
50
Acute Pyelonephritis II: Diagnostic Studies and Management01:28

Acute Pyelonephritis II: Diagnostic Studies and Management

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Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
40
Sexually Transmitted Infections01:26

Sexually Transmitted Infections

413
Sexually transmitted infections (STIs) are diseases transmitted primarily through unsafe sexual interactions. Bacteria, viruses, or parasites cause them and can result in severe health complications if untreated.ChlamydiaThe bacterium Chlamydia trachomatis is responsible for the disease Chlamydia, the most common STI in the United States. This peculiar pathogen requires human cells to reproduce, residing intracellularly. The initial infection often goes unnoticed because it typically does not...
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European Association of Urology Guidelines on Urological Infections: Summary of the 2026 Guidelines.

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Related Experiment Video

Updated: Sep 12, 2025

Transperineal Prostate Biopsy Using a Cone-shaped Double-hole Method with Dual-plane Probe Guidance
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Transperineal Prostate Biopsy Using a Cone-shaped Double-hole Method with Dual-plane Probe Guidance

Published on: June 6, 2025

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Infectious Complications After Transrectal Versus Transperineal Prostate Biopsy: A Systematic Review and

Fabian Peter Stangl1, Elizabeth Day2, Maxime Vallée3

  • 1Department of Urology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Department of Urology, Faculty of Medicine, Medical Center-University of Freiburg, University of Freiburg, Freiburg, Germany; Department of Urology and Andrology, Salzburg University Hospital, Paracelsus Medical University, Salzburg, Austria.

European Urology Focus
|August 7, 2025
PubMed
Summary

Transperineal (TP) prostate biopsies lead to fewer infectious complications and hospitalizations than transrectal (TR) biopsies. TP biopsies may be safely performed without antibiotics, supporting antimicrobial stewardship.

Keywords:
Prostate biopsyRehospitalisationSepsisTransperinealTransrectalUrinary tract infection

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Povidone Iodine Rectal Preparation at Time of Prostate Needle Biopsy is a Simple and Reproducible Means to Reduce Risk of Procedural Infection
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Area of Science:

  • Urology
  • Infectious Diseases
  • Oncology

Background:

  • Prostate biopsies are crucial for prostate cancer diagnosis, performed via transrectal (TR) or transperineal (TP) routes.
  • Both TR and TP approaches offer similar diagnostic accuracy, but TP biopsies are associated with fewer infectious complications.
  • Conflicting guidelines exist regarding the optimal prostate biopsy approach, highlighting the need for comparative analysis of infectious complications and antibiotic use.

Purpose of the Study:

  • To systematically review and compare infectious complications and antibiotic usage between transrectal (TR) and transperineal (TP) prostate biopsy techniques.
  • To evaluate the necessity of antibiotic prophylaxis for TP biopsies in alignment with antimicrobial stewardship principles.

Main Methods:

  • A systematic review and meta-analysis of randomized controlled trials (RCTs) were conducted, adhering to PRISMA guidelines.
  • Searches were performed across MEDLINE, Embase, Scopus, and Web of Science for studies up to April 1, 2025.
  • Infectious complications (fever, UTI, hospitalization) were assessed, with risk of bias evaluated using the RoB 2 tool and statistical analysis via funnel/forest plots and Egger's regression test.

Main Results:

  • Ten RCTs involving 4188 prostate biopsies were analyzed.
  • TP biopsy significantly reduced hospitalization for infectious complications by 77% (OR 0.23; 95% CI 0.10-0.54) compared to TR biopsy.
  • Post-biopsy fever was less frequent with TP (OR 0.68; 95% CI 0.52-0.89), and no significant difference in complications was found for TP biopsies with or without antibiotics.

Conclusions:

  • Transperineal (TP) prostate biopsy demonstrates a lower risk of post-procedural infectious complications and hospital admission compared to transrectal (TR) biopsy.
  • TP biopsy appears safe without antibiotic use in patients without specific risk factors, supporting enhanced antimicrobial stewardship in urological practice.