Systematic Review of Complications of Prostate Biopsy

Loeb, Stacy; Vellekoop, Annelies; Ahmed, Hashim U.; Catto, James W.F.; Emberton, Mark; Nam, Robert K.; Rosario, Derek J.; Scattoni, Vincenzo; Lotan, Yair

doi:10.1016/j.eururo.2013.05.049

Cited by 893 publications

(751 citation statements)

References 188 publications

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“…Additional cores should be obtained from DRE/TRUS suspicious areas. Oral or intravenous quinolones remain standard prophylactic antibiotics, in spite of the increasing resistance to quinolones, which is associated with a rise in severe and potentially lethal infectious complications [27]. Other biopsy complications include haematospermia (37%), heamaturia lasting more than 1 day (14.5%), rectal bleeding Following an initial negative biopsy, the indications for repeat biopsy are summarised in Table 5.…”

Section: Prostate Biopsymentioning

confidence: 99%

EAU-ESTRO-SIOG Guidelines on Prostate Cancer. Part 1: Screening, Diagnosis, and Local Treatment with Curative Intent

et al. 2017

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Section: Prostate Biopsymentioning

confidence: 99%

EAU-ESTRO-SIOG Guidelines on Prostate Cancer. Part 1: Screening, Diagnosis, and Local Treatment with Curative Intent

et al. 2017

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“…Post-procedural bleeding, voiding dysfunctions and pain are common 1 , but are not clinically significant and seldom troublesome. Both patient-related (i.e.…”

Section: Bleedingmentioning

confidence: 99%

“…It is estimated that more than 2 million procedures are carried out in the United States and Europe every year 1,2 . Although prostate biopsy is often performed transrectally in an outpatient setting, they can also be performed via a transperineal approach, avoiding the rectum.…”

Section: Introductionmentioning

confidence: 99%

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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“…3 Because of the additional number of samples there is a significant risk of complications (infection, bleeding, acute urinary retention), anxiety and social-sanitary costs. 4 Recently various biomarkers have been studied to increase the ability to predict PCa diagnosis, especially in patients with persistent suspicion of cancer and a previous negative PB. The most promising biomarkers are PCA3 and [-2]proPSA (p2PSA), along with its derivative, the Prostate Health Index.…”

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confidence: 99%

The Roles of Multiparametric Magnetic Resonance Imaging, PCA3 and Prostate Health Index—Which is the Best Predictor of Prostate Cancer after a Negative Biopsy?

et al. 2014

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Purpose: In patients with a negative prostate biopsy and persistent suspicion of prostate cancer, additional analyses such as the PCA3 score, PHI and multiparametric magnetic resonance imaging have been proposed to reduce the number of unnecessary repeat biopsies. In this study we evaluate the diagnostic accuracy of PCA3, PHI, multiparametric magnetic resonance imaging and various combinations of these tests in the repeat biopsy setting. Materials and Methods: A total of 170 patients with an initial negative prostate biopsy and persistent suspicion of prostate cancer were enrolled in this prospective study. The patients underwent measurements of the total prostate specific antigen and free prostate specific antigen rate, along with PHI, PCA3 tests and multiparametric magnetic resonance imaging before standard repeat biopsy that was performed by urologists blinded to the multiparametric magnetic resonance imaging results. Multivariate logistic regression models with various combinations of PCA3, PHI and multiparametric magnetic resonance imaging were used to identify the predictors of prostate cancer with repeat biopsy, and the performance of these models was compared using ROC curves, AUC analysis and decision curve analysis. Results: In the ROC analysis the most significant contribution was provided by multiparametric magnetic resonance imaging (AUC 0.936), which was greater than the contribution of the PHIþPCA3 model (p <0.001). In the multivariate logistic regression analysis only multiparametric magnetic resonance imaging was a significant independent predictor of prostate cancer diagnosis with repeat biopsy (p <0.001). The results of the decision curve analysis confirmed that the most significant improvement in the net benefit was provided by multiparametric magnetic resonance imaging.

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Systematic Review of Complications of Prostate Biopsy

Cited by 893 publications

References 188 publications

EAU-ESTRO-SIOG Guidelines on Prostate Cancer. Part 1: Screening, Diagnosis, and Local Treatment with Curative Intent

EAU-ESTRO-SIOG Guidelines on Prostate Cancer. Part 1: Screening, Diagnosis, and Local Treatment with Curative Intent

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

The Roles of Multiparametric Magnetic Resonance Imaging, PCA3 and Prostate Health Index—Which is the Best Predictor of Prostate Cancer after a Negative Biopsy?

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