Emergency attendances and hospitalisations for complications after transrectal ultrasound-guided prostate biopsies: a five-year retrospective multicentre study

Abstract

Transrectal ultrasound-guided (TRUS) prostate biopsy is an established procedure for diagnosis of prostate cancer. Complications after TRUS biopsy are not well reported in Hong Kong. This study evaluated the 5-year incidences of TRUS biopsy complications and potential risk factors for those complications. Methods: This was a retrospective review of biopsies performed from 2013 to 2017 in two local hospitals, using data retrieved from electronic medical records. The primary outcome was the occurrence of complications requiring either emergency attendances or hospitalisations within 30 days after biopsy. Potential risk factors were examined using multiple logistic regression analysis. Results: In total, 1699 men were included (mean age ± standard deviation: 67 ± 7 years; median prostatespecific antigen level: 7.9 µg/L [interquartile range, 5.5-12.6 µg/L]); 4.3% had pre-biopsy bacteriuria. Overall, 5.7% and 3.8% of post-biopsy complications required emergency attendances and hospitalisations, respectively. Gross haematuria and rectal bleeding requiring emergency attendances developed in 2.1% and 0.4% of men; 0.8% and 0.4% required hospitalisations. Furthermore, 1.5% of men developed acute urinary retention requiring hospitalisations; 1.9% and 1.2% had post-biopsy infections requiring emergency attendances and

The negative aftermath of prostate biopsy: prophylaxis, complications and antimicrobial stewardship: results of the global prevalence study of infections in urology 2010–2019

“…Prostate biopsy (P-Bx) is one of the most commonly performed urological procedures worldwide, more than one million biopsies are performed annually in the United States alone [ 1 ]. Since introduction of transrectal biopsies, the symptomatic infectious complications rates have varied from 1.9 to 27.7% and have tended to increase [ 2 – 7 ]. Apart from the contamination category of the procedure, risk factors for post-biopsy infections remain unclear.…”

Endoscopic Therapy in the Management of Patients With Severe Rectal Bleeding Following Transrectal Ultrasound-Guided Prostate Biopsy: A Case-Based Systematic Review

“…As per the results of our analysis, the rate of rectal bleeding demonstrated a remarkable heterogeneity, ranging from 0% to 37.1% ( Table 1 ). 13 - 39 Notably, the clear stratification between mild, moderate, and severe bleeding in individual studies was not clearly delineated. However, most patients experienced minor bleeding episodes that were amenable to traditional conservative measures.…”

Primum non nocere (first, to do no harm) in prostate biopsy

“…In Chinese men with prostate-specific antigen (interquartile range, 5.5-12.6 ng/mL), the positive biopsy rate reported by Cheng et al is 19.8%. 3 This is much lower than the reported rates of 26% to 47% in Caucasian series with prostate-specific antigen <10 ng/mL. 8 This is a commonly reported phenomenon among Asian or Chinese men, and indicates that, if most biopsy decisions are based on prostate-specific antigen alone, Chinese or Asian men may undergo more unnecessary biopsies than do Caucasian men.…”