Hemorrhoidal bleeding following transrectal prostatic biopsy. Etiology and management

Area of Science:

• Urology
• Gastroenterology

Background:

• Transrectal prostatic biopsy is a common procedure for diagnosing prostate cancer.
• Rectal bleeding is a potential complication, though typically minor.

Observation:

• Three patients undergoing transrectal prostatic biopsy experienced significant rectal bleeding.
• Hemorrhoids, unsuspected prior to biopsy, were identified as the cause in these cases.

Findings:

• Balloon tamponade with a 24 French Foley catheter successfully arrested rectal bleeding in all three patients.
• The technique was simple, safe, and effective, with no reported complications.
• Continuous monitoring of the rectal Foley catheter was stopped once bleeding ceased.

Implications:

• This case series highlights the importance of considering hemorrhoids as a cause of rectal bleeding post-biopsy.
• Preliminary proctoscopy may be beneficial in patients with suspected hemorrhoids to guide surgical approach.
• Foley catheter balloon tamponade offers a safe and effective management strategy for post-biopsy rectal hemorrhage.