Antimicrobial lubricant reduces rectal bacteria at transrectal prostate biopsy: results from a prospective randomized trial

Salomon, Georg; Saul, J. P.; Prues, Sandra; Schneider, Meike; Budäus, Lars; Tilki, Derya; Rohde, Holger; Haferkamp, Axel; Graefen, Markus; Boehm, Katharina

doi:10.1007/s00345-018-2221-y

Cited by 7 publications

(4 citation statements)

References 20 publications

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“…The systematic reviews found that a povidone‐iodine enema can significantly reduce the risk of bacteraemia and bacteriuria however rectal enema did not reduce 6,20 . A randomised control study comparing antimicrobial and standard lubricants demonstrated that the antimicrobial option significantly decreased bacterial colonisation; however did not reduced quinolone resistance bacterial growth and also reported that there was significant difference between groups in terms of fever and readmission rate 21 . Additionally, targeted antimicrobial prophylaxis using rectal swab made a notable reduction of infectious complications because of fluoroquinolone microorganism.…”

Section: Discussionmentioning

confidence: 99%

“…6,20 A randomised control study comparing antimicrobial and standard lubricants demonstrated that the antimicrobial option significantly decreased bacterial colonisation; however did not reduced quinolone resistance bacterial growth and also reported that there was significant difference between groups in terms of fever and readmission rate. 21 Additionally, targeted antimicrobial prophylaxis using rectal swab made a notable reduction of infectious complications because of fluoroquinolone microorganism. However, the authors also emphasised that 38 men needed to undergo rectal swab to prevent one potentially infectious complication.…”

Section: Discussionmentioning

confidence: 99%

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A novel enema method can prevent infectious complications of transrectal ultrasound‐guided prostate biopsy: A single‐centre experience

Gökalp

Koraş

Gürsoy

et al. 2021

Int J Clinical Practice

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Background TRUS biopsy is the preferred method for diagnosing prostate cancer, but it can cause infectious complications that arise with the contribution of fluoroquinolone resistance. We aimed to explore the potential protective effect of a second rectal enema before biopsy. Methods From January 2015 to December 2020, 419 patients were assessed retrospectively. Patients with a history of anticoagulant use, uncontrolled diabetes, urological surgery, prostate biopsy or recent hospitalisation or overseas travel, as well as those with the previous prostatitis, were excluded from the study. The patients were subsequently divided into two groups: Group 1 (n = 223) had received one enema, on the morning of the biopsy and Group 2 (n = 196) had received two, with the additional enema administered half an hour before the procedure. Results There was no significant difference between the groups in terms of age(P = .076), BMI (P = .489), diabetes (P = .265), prostate‐specific antigen (PSA) level (P = .193), free/total PSA (f/t PSA) ratio (P = .518) and prostate size (P = .661) or in relation to cancer detection (P = .428). The median hospitalisation date was significantly higher in Group 1 (P = .003) as was urinary tract infection (UTI) development (P = .004). However, there was no significant difference in terms of fever and sepsis (P = .524 and P = .548, respectively). Additionally, subgroup analysis demonstrated that UTI was significantly lower in patients with diabetes mellitus who had received a second enema (P = .004), though there was no significant difference in UTI between the groups in those without diabetes mellitus (P = .215). Multivariable analysis showed that age and diabetes were significant risk factors for the development of UTI (OR: 1.074, 95% CI: 1.027‐1.130, P = .002 and OR: 1.220, 95% CI: 0.131‐0.665, P = .003, respectively). Furthermore, the second enema was a significant protective factor for preventing UTI (OR: −1.794, 95% CI: 2.208‐16.389, P < .001). Conclusion Older age and the presence of diabetes mellitus are independent risk factors for UTI after prostate biopsy. A second enema procedure before biopsy may protect patients from related infectious complications and could therefore be used as an alternative preventative method.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A novel enema method can prevent infectious complications of transrectal ultrasound‐guided prostate biopsy: A single‐centre experience

Gökalp

Koraş

Gürsoy

et al. 2021

Int J Clinical Practice

View full text Add to dashboard Cite

show abstract

“…A further systematic review found that a povidone-iodine enema can significantly reduce the risk of bacteremia and bacteriuria (5). A randomized control study comparing antimicrobial and standard lubricants demonstrated that the antimicrobial option significantly decreased bacterial colonization; however did not reduced quinolone resistance bacterial growth and also reported that there was significant difference between groups in terms of fever and readmission rate (20).…”

Section: Discussionmentioning

confidence: 99%

A Novel Enema Method Can Prevent Infectious Complications of Transrectal Ultrasound-Guided Prostate Biopsy: A Single-Center Experience

Gökalp

Koraş

Gürsoy

et al. 2021

Preprint

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Background: Transrectal ultrasound biopsy is the preferred method for diagnosing prostate cancer, but it can cause infectious complications as a result of fluoroquinolone resistance. We aimed to explore the potential protective effect of a second rectal enema before biopsy. Methods: Between January 2015 and December 2020, 419 patients were assessed retrospectively. Patients with a history of anticoagulant use, uncontrolled diabetes, urological surgery, prostate biopsy, or recent hospitalization or overseas travel, as well as those with previous prostatitis, were excluded from the study. The patients were subsequently divided into two groups: Group 1 (n=223) had received one enema, on the morning of the biopsy, and Group 2 (n=196) had received two, with the additional enema administered half an hour before the procedure. Results: There was no significant difference between the groups in terms of age, BMI, diabetes, prostate-specific antigen (PSA) level, and prostate size (p=0.076, p=0.489, p=0.265, p=0.193, and p=0.661, respectively) or in relation to cancer detection (p=0.428). The median hospitalization date was significantly higher in Group 1 (p=0.003) as was UTI development (p=0.004). However, there was no significant difference in terms of fever and sepsis (p=0.524 and p=0.548, respectively). Additionally, subgroup analysis demonstrated that UTI was significantly lower in patients with diabetes mellitus who had received a second enema (p=0.004), though there was no significant difference in UTI between the groups in those without diabetes mellitus (p=0.215). Multivariable analysis showed that age and diabetes were significant risk factors for the development of UTI (p=0.002andp=0.003, respectively). Furthermore, the second enema was a significant protective factor for preventing UTI (p<0.001). Conclusion: Older age and the presence of diabetes mellitus are independent risk factors for UTI after prostate biopsy. A second enema procedure before biopsy may protect patients from related infectious complications and could therefore be used as an alternative preventative method.

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“…Here, two RCTs including 209 men demonstrated a comparable number of infectious complications following prostate biopsy [42,43]. Instead of using the standard lubricant an antimicrobial lubricant was evaluated in another RCT showing a reduction of the bacterial counts in the rectum without a benefit of postbiopsy infections [44].…”

Section: Rectal Preparationmentioning

confidence: 99%

Update on Strategies to Reduce Infectious Complications After Prostate Biopsy

Pilatz

Veeratterapillay

Köves³

et al. 2019

European Urology Focus

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Antimicrobial lubricant reduces rectal bacteria at transrectal prostate biopsy: results from a prospective randomized trial

Cited by 7 publications

References 20 publications

A novel enema method can prevent infectious complications of transrectal ultrasound‐guided prostate biopsy: A single‐centre experience

A novel enema method can prevent infectious complications of transrectal ultrasound‐guided prostate biopsy: A single‐centre experience

A Novel Enema Method Can Prevent Infectious Complications of Transrectal Ultrasound-Guided Prostate Biopsy: A Single-Center Experience

Update on Strategies to Reduce Infectious Complications After Prostate Biopsy

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