Complication rates and risk factors of 5802 transrectal ultrasound-guided sextant biopsies of the prostate within a population-based screening program

Raaijmakers, René; Kirkels, Wim J.; Roobol, Monique J.; Wildhagen, Mark F.; SCHR??DER, FRITZ H.

doi:10.1016/s0090-4295(02)01958-1

Cited by 352 publications

(253 citation statements)

References 19 publications

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“…Indeed, in a large prospective study, rectal bleeding was common (36.8%), but only 2.5% of all patients found it a major or moderate problem according to the National Cancer Institute's criteria 7 . Lower rates were reported within the ERSPC study (1.3%), with no correlation between hematochezia and other clinical parameters 11 . Ghani et al reported a significantly higher rates of rectal bleeding in men undergoing more biopsy cores (17% vs. 26% vs. 27% after six, eight and 12-core biopsy, respectively) 4 .…”

Section: Rectal Bleedingmentioning

confidence: 57%

“…In a large prospective cohort from the UK screening study, Rosario et al reported hematospermia in 92.6% of patients within 35 days after PB, and 26.6% perceived it as a moderate/serious and bothersome problem 7 . In the ERSPC study, hematospermia was reported in 50.4%, and was inversely correlated with age (p<0.001), previous transurethral resection of the prostate (p<0.001) and prostate volume (p<0.001) 11 . Regardless of the procedural approach, the number of cores can influence incidence of hematospermia.…”

Section: Hematospermiamentioning

confidence: 97%

“…In a large prospective cohort of 1147 men undergoing TRUS-guided PB, hematuria was reported by 65.8% of patients within 35 days, but only 6.2% of them considered it bothersome 7 . In the European Randomized Study for Prostate Cancer (ERSPC), hematuria lasting more than 3 days occurred in 22.6% of cases, and was significantly correlated with higher prostate and transition zone volumes (p<0.001) 11 . The impact of the number of biopsy cores on hematuria is controversial, irrespective of the technique (TRUSguided or transperineal).…”

Section: Hematuriamentioning

confidence: 99%

“…The presence of visible blood in the ejaculate is the most variably reported complication after prostate biopsy, ranging from 1.1%-92.6% 1,5,7,11,13,17 . Unlike hematuria or rectal bleeding, hematospermia could have a transient detrimental effect on sexual activity or trigger anxiety 7,17 .…”

Section: Hematospermiamentioning

confidence: 99%

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Complications After Systematic, Random, and Image-guided Prostate Biopsy

et al. 2017

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Evidence Synthesis: The most frequent complication after PB is minor and self-limiting bleeding (hematuria and hematospermia), irrespective of the biopsy approach. Occurrence of rectal bleeding was comparable among traditional TRUS-guided and image-guided PB. Almost 25% of patients experience lower urinary tract symptoms, but only a few have urinary retention, with higher rates after transperineal approach. Temporary erectile dysfunction is not negligible, with a return to baseline after 1-6 months. The incidence of infective complications is being increasing, with higher rates among men with medical comorbidities and older age. Transperineal and in-bore MRI targeted biopsy may reduce the risk of severe infectious complications. Mortality after PB is uncommon, irrespective of biopsy technique. Conclusions:Complications after PB are frequent but often self-limiting. The incidence of hospitalization due to severe infections is continuously increasing. Still, a careful appraisal of 3 patient's general health status, risk factors and likelihood of antimicrobial resistance should be done before scheduling a PB. Patient Summary:In this paper we reviewed the variety and incidence of complications after prostate biopsy. Even if frequent, seldom represent a problem for the patient. The most troublesome complications are infections. In order to minimize this risk, a careful evaluation of patient's medical condition must be done before biopsy.4

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Section: Rectal Bleedingmentioning

confidence: 57%

Section: Hematospermiamentioning

confidence: 97%

Section: Hematuriamentioning

confidence: 99%

Section: Hematospermiamentioning

confidence: 99%

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Complications After Systematic, Random, and Image-guided Prostate Biopsy

et al. 2017

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“…4 Recently, there have been studies investigating urinary and erectile function after prostate biopsy. 2,3,5 There are few publications on preoperative and postoperative impact of serial prostate biopsies on active surveillance patients who ultimately undergo RARP.…”

Section: Discussionmentioning

confidence: 99%

The impact of multiple biopsies on outcomes of nerve-sparing robotic-assisted radical prostatectomy

et al. 2012

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Active surveillance of prostate cancer patients involves subjecting them to multiple prostate biopsies, and we sought to investigate the effects of this on functional outcomes after robotic-assisted radical prostatectomy (RARP). Between May 2009 and December 2009, 367 patients who consecutively underwent RARP by a single surgeon were divided into two groups, one that had single prostate biopsy and another multiple biopsies before RARP. The groups were matched for significant clinicopathologic preoperative variables, and only premorbidly potent low-risk cases that underwent nerve sparing were included. This left 50 and 23 patients for analysis in the single and multiple biopsy groups, respectively. The primary endpoint was potency and continence at 3 and 6 months after surgery. We found continence rates of 84% (83%) and 94% (96%) for single (multiple) biopsy groups at 3 and 6 months, respectively (P ¼ 0.88, P ¼ 0.77). Multiple biopsy patients had worse postoperative erectile function at 6 months (57% versus 80%, P ¼ 0.03). Men subject to multiple preoperative biopsies are more likely to become impotent postoperatively than those who undergo surgery after a single biopsy. This should be borne in mind when counseling men regarding repeat biopsy as part of an active surveillance strategy.

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Screening for Prostate Cancer

Grossman

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Owens

et al. 2018

JAMA

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223

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US Preventive Services Task Force IMPORTANCEIn the United States, the lifetime risk of being diagnosed with prostate cancer is approximately 11%, and the lifetime risk of dying of prostate cancer is 2.5%. The median age of death from prostate cancer is 80 years. Many men with prostate cancer never experience symptoms and, without screening, would never know they have the disease. African American men and men with a family history of prostate cancer have an increased risk of prostate cancer compared with other men.OBJECTIVE To update the 2012 US Preventive Services Task Force (USPSTF) recommendation on prostate-specific antigen (PSA)-based screening for prostate cancer.EVIDENCE REVIEW The USPSTF reviewed the evidence on the benefits and harms of PSA-based screening for prostate cancer and subsequent treatment of screen-detected prostate cancer. The USPSTF also commissioned a review of existing decision analysis models and the overdiagnosis rate of PSA-based screening. The reviews also examined the benefits and harms of PSA-based screening in patient subpopulations at higher risk of prostate cancer, including older men, African American men, and men with a family history of prostate cancer.FINDINGS Adequate evidence from randomized clinical trials shows that PSA-based screening programs in men aged 55 to 69 years may prevent approximately 1.3 deaths from prostate cancer over approximately 13 years per 1000 men screened. Screening programs may also prevent approximately 3 cases of metastatic prostate cancer per 1000 men screened. Potential harms of screening include frequent false-positive results and psychological harms. Harms of prostate cancer treatment include erectile dysfunction, urinary incontinence, and bowel symptoms. About 1 in 5 men who undergo radical prostatectomy develop long-term urinary incontinence, and 2 in 3 men will experience long-term erectile dysfunction. Adequate evidence shows that the harms of screening in men older than 70 years are at least moderate and greater than in younger men because of increased risk of false-positive results, diagnostic harms from biopsies, and harms from treatment. The USPSTF concludes with moderate certainty that the net benefit of PSA-based screening for prostate cancer in men aged 55 to 69 years is small for some men. How each man weighs specific benefits and harms will determine whether the overall net benefit is small. The USPSTF concludes with moderate certainty that the potential benefits of PSA-based screening for prostate cancer in men 70 years and older do not outweigh the expected harms.CONCLUSIONS AND RECOMMENDATION For men aged 55 to 69 years, the decision to undergo periodic PSA-based screening for prostate cancer should be an individual one and should include discussion of the potential benefits and harms of screening with their clinician. Screening offers a small potential benefit of reducing the chance of death from prostate cancer in some men. However, many men will experience potential harms of screening, including false-positive results that r...

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Complication rates and risk factors of 5802 transrectal ultrasound-guided sextant biopsies of the prostate within a population-based screening program

Cited by 352 publications

References 19 publications

Complications After Systematic, Random, and Image-guided Prostate Biopsy

Complications After Systematic, Random, and Image-guided Prostate Biopsy

The impact of multiple biopsies on outcomes of nerve-sparing robotic-assisted radical prostatectomy

Screening for Prostate Cancer

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