Nationwide Population Based Study of Infections after Transrectal Ultrasound Guided Prostate Biopsy

Lundström, Karl-Johan; Drevin, Linda; Carlsson, Stefan; Garmo, Hans; Loeb, Stacy; Stattin, Pär; Bill‐Axelson, Anna

doi:10.1016/j.juro.2014.04.098

Cited by 85 publications

(69 citation statements)

References 16 publications

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“…Asymptomatic bacteriuria, febrile urinary tract infections (UTI), acute bacterial prostatitis, orchitis, epididymitis, and urinary sepsis represent the broad spectrum of possible infectious complications 1,45,46 . Accordingly, antibiotic prophylaxis is recommended as the standard of care 1,47,48 .…”

Section: Infectious Complications and Hospitalization Rates After Promentioning

confidence: 99%

Section: Infectious Complications and Hospitalization Rates After Promentioning

confidence: 99%

“…Fluoroquinolone resistant organisms have been identified in 10-30% of patients undergoing rectal swab culture before PB 47,[49][50][51][52] , although rates of clinical infectious complications are lower at approximately 1-17.5% 7,45,46,48,[53][54][55][56][57] . Most infections are self-limiting and can be managed in the outpatient setting 7,45 . However, the incidence of more serious infectious complications requiring hospitalization has dramatically increased over time 2,15,[58][59][60] , with fluoroquinolone-resistant (FQR) Escherichia Coli as the most recognized risk factor 2,45,47,[49][50][51]53 .…”

Section: Infectious Complications and Hospitalization Rates After Promentioning

confidence: 99%

“…Most infections are self-limiting and can be managed in the outpatient setting 7,45 . However, the incidence of more serious infectious complications requiring hospitalization has dramatically increased over time 2,15,[58][59][60] , with fluoroquinolone-resistant (FQR) Escherichia Coli as the most recognized risk factor 2,45,47,[49][50][51]53 . In this scenario, patients with biopsy-related bacterial acute prostatitis have a higher risk of sepsis when compared to those with spontaneous acute prostatitis, probably due to a different pathogenic bacterial strain among the two groups 61 .…”

Section: Infectious Complications and Hospitalization Rates After Promentioning

confidence: 99%

“…In this scenario, patients with biopsy-related bacterial acute prostatitis have a higher risk of sepsis when compared to those with spontaneous acute prostatitis, probably due to a different pathogenic bacterial strain among the two groups 61 . Furthermore, medical comorbidities (particularly diabetes or metabolic syndrome) and older age are independent predictors increasing the risk of infections and sepsis 45,58,60,62 . A previous history of prostatitis, antibiotics within 6 months before PB, and non-adherence to antibiotic prophylaxis represent other risk factors 46 .…”

Section: Infectious Complications and Hospitalization Rates After Promentioning

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: Infectious Complications and Hospitalization Rates After Promentioning

confidence: 99%

Section: Infectious Complications and Hospitalization Rates After Promentioning

confidence: 99%

Section: Infectious Complications and Hospitalization Rates After Promentioning

confidence: 99%

Section: Infectious Complications and Hospitalization Rates After Promentioning

confidence: 99%

Section: Infectious Complications and Hospitalization Rates After Promentioning

confidence: 99%

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

et al. 2017

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A Novel Urine Exosome Gene Expression Assay to Predict High-grade Prostate Cancer at Initial Biopsy

et al. 2016

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This urine exosome gene expression assay is a noninvasive, urinary 3-gene expression assay that discriminates high-grade (≥GS7) from low-grade (GS6) cancer and benign disease. In this study, the urine exosome gene expression assay was associated with improved identification of patients with higher-grade prostate cancer among men with elevated PSA levels and could reduce the total number of unnecessary biopsies.

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How Many Cores Does Systematic Prostate Biopsy Need?: A Large‐Sample Retrospective Analysis

Wang

Sun

et al. 2018

J of Ultrasound Medicine

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Objectives To explore the best individualized systematic prostate biopsy method. Methods We retrospectively analyzed the clinical data of 1211 patients who underwent 12‐core systematic prostate biopsy guided by transrectal ultrasound from January 2011 to March 2018. Other biopsy core methods (6‐, 8‐, and 10‐core) were estimated from the 12‐core biopsy that was performed. Differences in the detection rates of prostate cancer (PCa) and clinically significant prostate cancer (csPCa) were compared. Results A total of 498 cases of PCa (41.1%) were detected, and 423 cases (34.9%) were csPCa. There was no significant difference between the 12‐ and 10‐core prostate biopsy strategies in the total detection rates of PCa and csPCa (P > .05). In the subgroup of patients with a maximal prostate cross‐sectional area of less than 15 cm2, there was a significant difference between the 12‐core method and the standard 6‐core method (P = .03) but no significant differences between the other methods in the detection rate of PCa (P > .05), but in the detection rate of csPCa, the 12‐core method differed significantly from the other methods (P = .02–.04) except for the 10‐core method (P > .05). In patients with a prostate‐specific antigen concentration of 20 ng/mL or higher, there were no significant differences between the 12‐core method and all of the other methods (P > 0.05). In patients younger than 70 years and 70 years or older, the 12‐core method differed significantly from the other methods (P < .01–.03) except for the 10‐core method (P > .05). Conclusions Ten‐ or 12‐core biopsy showed a higher detection rate than the other schemes. However, for patients with a prostate‐specific antigen concentration of 20 ng/mL or higher, the 6‐core systematic biopsy is preferred.

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Nationwide Population Based Study of Infections after Transrectal Ultrasound Guided Prostate Biopsy

Abstract: Severe infections with hospitalization after prostate biopsy are increasing in Sweden. The risk of post-biopsy infection is highest in men with a history of urinary tract infection and those with significant comorbidities.

Cited by 85 publications

References 16 publications

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

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

A Novel Urine Exosome Gene Expression Assay to Predict High-grade Prostate Cancer at Initial Biopsy

How Many Cores Does Systematic Prostate Biopsy Need?: A Large‐Sample Retrospective Analysis

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