Condom perforation during transrectal ultrasound guided (TRUS) prostate biopsies: a potential infection risk

Abstract

We have demonstrated a significant condom perforation rate (9%) amongst patients undergoing prostate biopsies. This raises the serious issue of hygiene and cross infection, particularly with blood borne communicable diseases such as hepatitis and HIV unless strict disinfection and sterilization protocols are followed between patients. Perforation of the condoms used during TRUS guided prostate biopsy and hence faecal and blood contamination of the biopsy equipment could potentially have far-reaching implications for urologists and the infection control community. Although the risk of cross infection is probably small this serious issue needs addressing.

Infection prevention and ultrasound probe decontamination practices in Europe: a survey of the European Society of Radiology

“…The latter is important, as varying rates of probe cover perforations have been reported, ranging from 2 % [24] to 9 % of cases [25], and even up to 81 % in one older study [26]. Less frequent perforations were reported when condoms were used for trans-vaginal US rather than US probe covers [27, 28], but published studies are somewhat dated.…”

EFSUMB Guidelines on Interventional Ultrasound (INVUS), Part I

“…Only sterile, disposable transducer covers should be used in interventional procedures [34]. Sterile transducer covers do not eliminate the need for transducer decontamination [35 -37].…”

Hygiène en échographie endocavitaire gynécologique et obstétricale en 2008

“…Les contrôles bactério-logiques à partir de sondes d'échographie endovaginale recouvertes de ces gaines ont montré la présence de bacté-ries résiduelles dans un cas (Acinetobacter sp) sur 46 testés et la perforation de 0,9 % des préservatifs. Le taux global de perforation varie selon les publications de 1 à 9 % [14][15][16]. Tableau 1 Critères de l'évaluation du risque infectieux lié aux échographies endocavitaires, en l'absence de protection ou de désinfection des sondes entre patients.…”

“…L'aiguille de ponction/biopsie est passée à plusieurs reprises à travers le guide. L'aiguille et le guide doivent donc être toujours sté-rilisés [16,30]. Avant la stérilisation, le matériel doit être nettoyé méticuleusement puisqu'un nettoyage méticuleux est la principale étape dans la réduction initiale de la charge microbienne (99 %) [12].…”