Peri-procedural povidone-iodine rectal preparation reduces microorganism counts and infectious complications following ultrasound-guided needle biopsy of the prostate

Gyorfi, Justin; Otteni, Christopher; Brown, Kevin E.; Patel, Amrish; Lehman, Kathleen; Phillips, Brett E.; Dewan, Kalyan K.; Kirimanjeswara, Girish S.; Raman, Jay D.

doi:10.1007/s00345-014-1291-8

Cited by 21 publications

(16 citation statements)

References 17 publications

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“…From metaanalysis of seven controlled trials (n = 2,049) of rectal disinfection using PIRP prior to TRUBP, significant reductions in fever, bacteruria and bacteraemia (RR 0.31; 95% CI 0.21 -0.45) regardless of prophylaxis used have been reported 88 . Recent retrospective studies further report significant reductions in infectious complications when PIRP was used 89 , as well as in conjunction with targeted prophylaxis 90 . However, a randomised controlled trial of prophylactic povidone-iodine use demonstrated insignificantly reduced complication rates (2.6%) compared with control (4.5%), in a study that is likely to have been underpowered 91 .…”

Section: Rectal Disinfectionmentioning

confidence: 99%

Prostate Biopsy-related Infection: A Systematic Review of Risk Factors, Prevention Strategies, and Management Approaches

Roberts

Bennett

Harris

et al. 2017

Urology

116

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Section: Rectal Disinfectionmentioning

confidence: 99%

Prostate Biopsy-related Infection: A Systematic Review of Risk Factors, Prevention Strategies, and Management Approaches

Roberts

Bennett

Harris

et al. 2017

Urology

116

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“…Perhaps, a convincing argument for the use of preprocedural rectal povidone-iodine preparation comes from a retrospective study by Gyorfi et al 35 They utilized a slurry consisting of 10% povidone-iodine solution mixed with lidocaine jelly. All patients received standard prophylaxis, which included either a 3-day regimen of ciprofloxacin or trimethoprim sulfamethoxazole.…”

Section: Strategies For Preventing Pnb-related Infectionsmentioning

confidence: 99%

Strategies for prevention of ultrasound-guided prostate biopsy infections

Raman

2016

IDR

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Prostate cancer is the most common cancer in male patients and the second leading cause of cancer-related mortality in males. To confirm the diagnosis of prostate cancer, an ultrasound-guided needle biopsy is necessary to obtain prostate tissue sufficient for histologic analysis by pathologists. Ultrasound-guided prostate needle biopsy can be accomplished via a transperineal or transrectal approach. The latter biopsy technique involves placing an ultrasound probe into the rectum, visualizing the prostate located just anterior to it, and then obtaining 12–14 biopsies. Each biopsy core requires piercing of the rectal mucosa which can inherently contribute to infection. The increasing infectious risk of prostate needle biopsy requires refinement and re-evaluation of the process in which the technique is performed. Such processes include (but are not limited to) prebiopsy risk stratification, antibiotic prophylaxis, use of rectal preparations, and equipment processing. In the subsequent review, we highlight the current available information on different strategies to reduce the risk of infection following prostate needle biopsy.

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“…Povidone-iodine is an easily accessed, cheap antiseptic solution commonly used to clean the surgical field for daily surgical procedures. As it is safe for mucosa, it is commonly used during gynecological and colorectal surgery [25]. A study by Park et al divided 408 patients undergoing biopsy into two groups of patients either administered povidone-iodine in suppository form for intestinal preparation or not.…”

Section: Discussionmentioning

confidence: 99%

Does Leaving the Biopsy Needle in Povidone-Iodine Solution Reduce Infective Complications after Biopsy?

Benli̇

Çırakoğlu

Öğreden

et al. 2016

Advances in Urology

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Aim. The aim of this study is to evaluate whether leaving the biopsy needle used during prostate needle biopsy in 10% povidone-iodine (betadine) solution affects the infectious complications forming after biopsy. Material and Method. This study retrospectively evaluated the data of 176 patients with prostate biopsy performed between December 2012 and April 2014. Patients in Group 1 (n = 89) were given ofloxacin as a prophylactic antibiotic before biopsy. Patients in Group 2 (n = 87) had the biopsy needle left in povidone-iodine solution for 1 minute before each use, in addition to antibiotic prophylaxis. The two groups were compared in terms of infective complications developing after biopsy. Results were analyzed using the Mann–Whitney U test and Fisher's exact test. Results. The distribution of infective complications after biopsy according to group was as follows. Group 1, not using betadine, had 15.7% fever, 13.5% hospital stay, 12.4% urinary retention, 10.1% prostatitis, and 5.6% sepsis. The distribution of the same complications in Group 2 using betadine was identified as 5.7% fever, 4.6% hospital stay, 3.4% urinary retention, 2.3% prostatitis, and 0% sepsis. The use of betadine was found to significantly reduce the infectious complications after biopsy compared to the control group (p < 0.05). Conclusion. At the end of this study leaving the prostate needle in povidone-iodine solution before each use during prostate biopsy was found to reduce the infective complications and hospital stay after biopsy.

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Peri-procedural povidone-iodine rectal preparation reduces microorganism counts and infectious complications following ultrasound-guided needle biopsy of the prostate

Abstract: Peri-procedural PIRP decreased microorganism colony counts and effectively reduced infectious complications following TRUS PNB. This safe, cheap, and simple strategy may be a reasonable alternative to systemic or targeted antibiotic therapy to reduce post-biopsy infections.

Cited by 21 publications

References 17 publications

Prostate Biopsy-related Infection: A Systematic Review of Risk Factors, Prevention Strategies, and Management Approaches

Prostate Biopsy-related Infection: A Systematic Review of Risk Factors, Prevention Strategies, and Management Approaches

Strategies for prevention of ultrasound-guided prostate biopsy infections

Does Leaving the Biopsy Needle in Povidone-Iodine Solution Reduce Infective Complications after Biopsy?

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