Effect of rectal mucosa cleansing on acute prostatitis during prostate biopsy: A randomized prospective study

Ergani, Batuhan; Çetin, Taha; Yalçın, Metin; Özbilen, Mert Hamza; Bildirici, Çağdaş; Karaca, Erkin; Boyacıoğlu, Hayal; Koç, Gökhan; İlbey, Yusuf Özlem

doi:10.5152/tud.2019.19172

Cited by 9 publications

(12 citation statements)

References 15 publications

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“…Considering the nature of the passage from the rectal cavity to the prostatic lodge as a clean‐contaminated procedure, a few steps must be considered before a transrectal approach can be performed when attempting to lower the risk of perioperative infectious complications. Rectal preparation by enema is routinely recommended, and even though this practice facilitates a smoother procedure for the urologist, no significant advantage in its use before transrectal biopsy regarding infectious complications has been shown 46 . In contrast, studies have shown that the use of iodine‐povidone for rectal preparation before prostate biopsy, resulted in a lower rate of infectious complications 47 .…”

Section: Methods To Prevent Post‐transrectal Prostate Biopsy Infectionsmentioning

confidence: 99%

“…Rectal preparation by enema is routinely recommended, and even though this practice facilitates a smoother procedure for the urologist, no significant advantage in its use before transrectal biopsy regarding infectious complications has been shown. 46 In contrast, studies have shown that the use of iodine-povidone for rectal preparation before prostate biopsy, resulted in a lower rate of infectious complications. 47 Furthermore, a 4year prospective study including 3000 patients who were followed prospectively after prostate biopsy, also supported its use in addition to antimicrobial prophylaxis resulting in a lower infection complication rate.…”

Section: Other Interventionsmentioning

confidence: 99%

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Post‐prostate biopsy acute bacterial prostatitis and screening cultures using selective media: An overview

et al. 2022

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The development of several culture media and the availability to isolate and treat pathogens prior to a surgical procedure give us the ability to minimize treatmentrelated complications, and ultimately results in better outcomes for patients and avoidance of unwanted post-procedure inpatient admissions. In the last decade, an increasing incidence of multidrug-resistant Escherichia coli, especially extended-spectrum beta-lactamase-producing E. coli and fluoroquinolone-resistant pathogens, has been reported. These resistant species frequently colonize the rectal flora and gain access to the systemic circulation via the rectal plexus following a prostate biopsy. The bacteria can eventually lead to life-threatening complications, which is especially important in high-risk patients with multiple co-morbidities. Previously published studies have focused on the isolation of these pathogens with selective media before an invasive procedure and the potential benefits of incorporating the use of selective media as a mandatory pre-operative step. This preventive measure will allow us to offer a tailored prophylactic treatment that benefits patients and reduces the economic burden for the hospital.

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Section: Methods To Prevent Post‐transrectal Prostate Biopsy Infectionsmentioning

confidence: 99%

Section: Other Interventionsmentioning

confidence: 99%

Post‐prostate biopsy acute bacterial prostatitis and screening cultures using selective media: An overview

et al. 2022

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Section: Diagnostic Proceduresmentioning

confidence: 99%

“…Regarding the non-pharmacologic prophylaxis, rectal povidone-iodine preparation before the biopsy is mandatory to reduce by half the rate of infectious complications [RR 0.47, 95% CI 0.36-0.61]. 59,60 No differences were found in terms of risk of infection regarding needle guide type, needle type, needle size, or number of anesthetic injections for nerve-blockage. 54 Rectal culture should be performed to avoid infective complications following the procedure and a targeted prophylactic treatment should be started.…”

Section: Prostate Biopsymentioning

confidence: 99%

Antibiotic prophylaxis in urologic interventions: Who, when, where?

Marino,

Rossi,

Murri

et al. 2024

Urologia

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Background: Periprocedural prophylaxis in medicine encompasses the set of measures (physical, chemical, and pharmacological) used to reduce the risk of infection. Antibiotic prophylaxis (AP) refers to the administration of a short-term regimen of antibiotics shortly before a medical procedure to reduce the risk of infectious complications that can result from diagnostic and therapeutic interventions. The outspreading growth of multidrug-resistant bacterial species and changes in the bacterial local ecosystem have impeded the development of a unique scheme of AP in urology. Objectives: To review the literature and current guidelines regarding AP for urological diagnostic and therapeutic procedures, and to define agents, timing, and occasions when administering pharmacological prophylaxis. Secondly, according to current literature, to open new scenarios where AP can be useful or useless. Results: Major gaps in evidence still exist in this field. AP appears useful in many invasive procedures and some sub-populations at risk of infectious complications. AP is not routinely recommended for urodynamic exams, diagnostic cystoscopy, and extracorporeal shock-wave lithotripsy. The available data regarding the use of AP during the transperineal prostate biopsy are still unclear; conversely, in the case of the transrectal approach AP is mandatory. AP is still considered the gold standard for the prevention of postoperative infective complications in the case of ureteroscopy, percutaneous nephrolithotomy, endoscopic resection of bladder tumor, endoscopic resection of the prostate, and prosthetic or major surgery. Conclusion: The review highlights the complexity of determining the appropriate candidates for AP, emphasizing the importance of considering patient-specific factors such as comorbidities, immunocompetence, and the nature of the urologic intervention. The evidence suggests that a one-size-fits-all approach may not be suitable, and a tailored strategy based on the specific procedure and patient characteristics is essential.

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“…Vasovagal response was defined as bradycardia and hypotension during the biopsy. Acute prostatitis was defined as hospitalization for the first 30 days after biopsy due to urinary tract infection with fever (body temperature higher than 38.5°C) 9) . The definition of sepsis was based on the 2001 International Sepsis Definitions Conference 10) .…”

Section: Evaluation Of Clinical Parametersmentioning

confidence: 99%

Additional Mid-Peripheral Biopsies to the Systematic Lateral-Peripheral Sextant Biopsy Provides an Improvement in Prostate Cancer Detection in Japanese Men

Yoshioka

Sasaki

Yoshiike

et al. 2021

J St. Marianna Univ

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The aims of this study were to evaluate 1) in transrectal biopsy, whether additional 4-core biopsies of the mid-peripheral region after lateral-peripheral sextant biopsy in the peripheral zone can improve the prostate cancer detection rate, and 2) the preventive role of flomoxef sodium and levofloxacin against infectious complications. Material and Methods: We retrospectively analyzed the records of 1541 patients who underwent initial transrectal ultrasound guided prostate biopsies at our hospital between January 2003 and November 2016. Two hundred and fifty-one patients underwent sextant prostate biopsy and 1290 underwent 10-core biopsy. The cancer detection rates of these two methods were analyzed. Since April 2009, a single-dose of flomoxef sodium (500 mg) has been injected immediately before the 10-core biopsy in addition to levofloxacin for antimicrobial prophylaxis. The infectious complication rate among biopsied patients with or without flomoxef sodium was also evaluated. Results:The additional 4-cores biopsies significantly increased the cancer detection rate compared with sextant biopsy, especially in a subgroup of patients with a serum prostate specific antigen level of 4.0-10.0 ng/ml (38.5% vs 28.7%, p=0.032) without increasing the rate of clinically insignificant cancer (5.2% vs 7.5%, p=0.367). Moreover, the incidence rate of acute prostatitis in 10-core-biopsied patients who were administered flomoxef sodium in addition to levofloxacin was significantly lower than in those administered levofloxacin alone (0.4% vs 4.6%, p<0.0001). Conclusions:The additional 4-core biopsies significantly increased the cancer detection rate compared with sextant biopsy without increasing the rate of clinically insignificant cancer. Moreover, flomoxef sodium together with levofloxacin may have preventive effects against infectious complications.

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Effect of rectal mucosa cleansing on acute prostatitis during prostate biopsy: A randomized prospective study

Abstract: I n d e x e d i n P u b M e d , W e b o f S c i e n c e a n d S c o p u s Pankaj M. Joshi and Sanjay B. Kulkarni. A new technique of double-face buccal graft urethroplasty for female urethral strictures.

Cited by 9 publications

References 15 publications

Post‐prostate biopsy acute bacterial prostatitis and screening cultures using selective media: An overview

Post‐prostate biopsy acute bacterial prostatitis and screening cultures using selective media: An overview

Antibiotic prophylaxis in urologic interventions: Who, when, where?

Additional Mid-Peripheral Biopsies to the Systematic Lateral-Peripheral Sextant Biopsy Provides an Improvement in Prostate Cancer Detection in Japanese Men

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