Safety of transperineal 14‐core systematic prostate biopsy in diabetic men

Abstract

Objectives: To examine whether the transrectal ultrasound-guided transperineal 14-core prostate biopsy can be carried out safely in diabetic men and to determine adequate antimicrobial prophylaxis protocol in this setting. Methods: The present study included 539 men, 135 with concurrent diabetes mellitus (DM) and 404 without DM, who underwent transperineal extended 14-core biopsy due to elevated prostate-specific antigen Ն2.5 ng/mL and/or abnormal digital rectal examination. Any complication requiring prolonged hospitalization or rehospitalization during the 4-week post-biopsy period was considered major. All other complications were considered minor. Intensity of antimicrobial prophylaxis was prospectively reduced in a stepwise manner down to single dose of oral levofloxacin. Results: Except for DM, there was no significant difference in clinical background between the diabetic and non-diabetic men. The procedure was completed in all revealing prostate cancer in 42% of the diabetic men and 36% of the non-diabetic men (P = 0.23). Incidence of minor or major complications was not significantly different between the two groups. Minor complications were observed in 15.6% and 16.6% of each group, respectively, with voiding disturbance being the most common. No infectious major complication was observed regardless of the presence of DM. In the diabetic men, there was no statistical difference in incidence of biopsy-related complications according to modality of DM treatment, HbA1c level or antimicrobial prophylaxis protocol. Conclusions: Transperineal 14-core biopsy can be carried out without major infectious complications in diabetic men. Oral levofloxacin 300 mg once before the procedure seems to represent an effective antimicrobial prophylaxis in diabetic men without other risk of infection.

Transperineal biopsy prostate cancer detection in first biopsy and repeat biopsy after negative transrectal ultrasound‐guided biopsy: the Victorian Transperineal Biopsy Collaboration experience

“… (51%) and Vyas et al. (54%) (Table ) . The only other TPB series published in Australia was by Symons et al.…”

Acute bacterial prostatitis after transrectal ultrasound‐guided prostate biopsy: Epidemiological, bacteria and treatment patterns from a 4‐year prospective study

“…They concluded that transperineal biopsy can be carried out without major infectious complications in diabetic men. 19 Finally, it important to monitor these patients and inform them that they should contact the referral department at the beginning of the onset of symptoms. The present study showed full recovery with no urosepsis when the patients were admitted quickly and treated appropriately.…”

Diagnostic performance and safety of a three‐dimensional 14‐core systematic biopsy method

“…Each biopsy core was individually labelled so that the location of cancer‐positive cores could be analysed . Biopsy‐related complications were prospectively evaluated, as reported elsewhere, and those that required hospitalisation were assigned to the major category . Cancers were classified as biopsy‐based significant cancers when biopsy Gleason score (GS) was 4 + 3 or greater and/or percentage of positive cores was >50% and/or maximum cancer occupation was >50% and/or PSA density was >0.15 (definition 1), and when biopsy GS was 3 + 4 or greater and/or percentage of positive cores was >50% and/or maximum cancer occupation was >50% and/or PSA density was >0.15 (definition 2).…”