Transrectal ultrasound examination of the prostate: complications and acceptance by patients

Transrectal ultrasound scan (TRUS) of the prostate was performed on 511 patients, 391 of whom also underwent between 1 and 5 transrectal 1.2 mm core biopsies. The infection rate in the whole group was 4.1%; 32% of the patients were given antibiotic prophylaxis with norfloxacin 400 mg twice daily for 1 week and in this group the infection rate was 0.8%. In the remaining patients, who received 400 mg norfloxacin at the time of biopsy and another 400 mg the same evening, the infection rate was 5.6%. The only risk factor identified for post-biopsy infection was steroid medication. Only minor discomfort (or none at all) was reported by 95% of patients during the examination procedure. If TRUS was combined with core biopsy 92% reported either minor or no discomfort. Of 78 patients who experienced both finger-guided fine needle aspiration biopsy and TRUS-guided core biopsy 82% preferred the latter procedure. TRUS and core biopsy proved acceptable to most patients. Antibiotic treatment with 2 tablets of norfloxacin failed to prevent infection.