Transrectal ultrasound-guided prostate needle biopsy remains a safe method in confirming a prostate cancer diagnosis: a multicentre Australian analysis of infection rates

Parkin, Cameron James; Gilbourd, Daniel; Grills, Richard; Chapman, Sue; Weinstein, Sydney; Joshi, Neil; Indrajit, Balasubramaniam; Kam, Jonathan; Shepherd, Andrew; Gikenye, Njeri; Louie-Johnsun, Mark

doi:10.1007/s00345-021-03862-8

Cited by 6 publications

(4 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…TRUS-PB is the most frequent method for diagnosing prostate cancer nowadays and will likely continue to be in the foreseeable future [ 4 , 5 ]. The main drawback of TRUS-PB is the high post-interventional infection rate, which was altogether 4.5% in our cohort and is comparable to the available literature.…”

Section: Discussionmentioning

confidence: 99%

“…This technique however, requires retraining and new costly equipment which makes it unavailable for the vast majority of patients in the foreseeable future. Therefore, the transrectal approach with periinterventional antibiotic prophylaxis will remain the most common method world-wide and optimizing the antibiotic prophylaxis regimen for this procedure remains important [ 4 ]. For example trends in the UK have shown that over the past decade, TRUS-PB has been far more commonly performed than TPB, at a ratio of almost 4:1 [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Comparison of ciprofloxacin versus fosfomycin versus fosfomycin plus trimethoprim/sulfamethoxazole for preventing infections after transrectal prostate biopsy

Bovo,

Kwiatkowski,

Manka

et al. 2024

World J Urol

View full text Add to dashboard Cite

Background To evaluate antibiotic prophylaxis in transrectal prostate biopsies due to the recommendation of the European Medicines Agency (EMA): We describe our single center experience switching from ciprofloxacin to fosfomycin trometamol (FMT) alone and to an augmented prophylaxis combining fosfomycin and trimethoprim/sulfamethoxazole (TMP/SMX). Methods Between 01/2019 and 12/2020 we compared three different regimes. The primary endpoint was the clinical diagnosis of an infection within 4 weeks after biopsy. We enrolled 822 men, 398 (48%) of whom received ciprofloxacin (group-C), 136 (16.5%) received FMT (group-F) and 288 (35%) received the combination of TMP/SMX and FMT (group-BF). Results Baseline characteristics were similar between groups. In total 37/398 (5%) postinterventional infections were detected, of which 13/398 (3%) vs 18/136 (13.2%) vs 6/288 (2.1%) were detected in group-C, group-F and group-BF respectively. The relative risk of infectious complication was 1.3 (CI 0.7–2.6) for group-C vs. group-BF and 2.8 (CI 1.4–5.7) for group-F vs. group-BF respectively. Conclusion The replacement of ciprofloxacin by fosfomycin alone resulted in a significant increase of postinterventional infections, while the combination of FMT and TMP/SMX had a comparable infection rate to FQ without apparent adverse events. Therefore, this combined regimen of FMT and TMP/SMX is recommended.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparison of ciprofloxacin versus fosfomycin versus fosfomycin plus trimethoprim/sulfamethoxazole for preventing infections after transrectal prostate biopsy

Bovo,

Kwiatkowski,

Manka

et al. 2024

World J Urol

View full text Add to dashboard Cite

show abstract

“…Nevertheless, the widespread adoption of TRUSPB in clinical practice has drawn attention to its associated complications. After TRUSPB, patients commonly experience bleeding, discomfort, dysuria and urine retention, with infection being the most concerning and severe among these complications [15][16][17].…”

Section: Discussionmentioning

confidence: 99%

Analysis of risk factors for infection after transrectal ultrasound-guided prostate biopsy and analysis of the value of preoperative prophylactic antimicrobial use

2023

JOMH

View full text Add to dashboard Cite

This study aimed to identify risk factors associated with infections after Transrectal ultrasound-guided prostate biopsy (TRUSPB) and to analyze the efficacy of preoperative prophylactic antimicrobial administration. A retrospective analysis was conducted on 766 patients who underwent TRUSPB at our hospital from January 2020 to January 2023. Among them, 450 patients were given a three-day prophylactic course of antimicrobial fluoroquinolones before TRUSPB (Group A), while the remaining 316 patients were administered a single dose of 750 mg oral ciprofloxacin 1 h before TRUSPB (Group B). We calculated the incidence of post-TRUSPB infections in both groups and employed a binary logistic regression model to analyze factors influencing post-TRUSPB infections and evaluate the effectiveness of prophylactic antimicrobial use. Among the 766 patients who underwent prostate biopsy, 62 cases (8.1%) developed post-TRUSPB infections, and there was no statistically significant difference in the rate of post-TRUSPB infections and types of infections between Group A and Group B. Blood and urine cultures from all the 62 infected patients were positive, with Escherichia coli being the most commonly detected pathogen, demonstrating a positive detection rate of 100.0% and accounting for 76% of all infections. Logistic regression analysis identified age (Odds ratio (OR) = 1.15, 95% Confidence Interval (CI) 1.05-1.25), a history of diabetes mellitus (OR = 1.31, 95% CI 1.12-1.52), and history of indwelling urinary catheter within 7 days before biopsy (OR = 1.43, 95% CI 1.15-1.77) as risk factors for post-TRUSPB infections. In summary, a single application of ciprofloxacin demonstrated similar efficacy in reducing the risk of post-TRUSPB infection compared to a three-day course of oral fluoroquinolones before biopsy while also reducing the risk of quinolone resistance. Conversely, advanced age, comorbid diabetes mellitus, and a 7-day history of indwelling urinary catheter before TRUSPB increased the risk of post-TRUSPB infection.

show abstract

“…Since PCa is definitively diagnosed via histopathology, prostate biopsy is essential, and approximately 2.5 million prostate biopsies are performed worldwide annually [ 2 ]. More punctures in a single biopsy are associated with an improved PCa diagnostic rate, but also with more pain and complications [ 3 ]. Severe pain or complications may reduce the amount of tissue biopsied and ultimately decrease the PCa diagnostic rate [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Lower Dose of 5 mL of 1% Lidocaine is More Suitable than the Conventional 10 mL for Caudal Block in Transrectal Prostate Biopsy: A Retrospective Cohort Study

Ueda,

Sato,

Mori

et al. 2024

Advances in Urology

View full text Add to dashboard Cite

Objectives. In Japan, caudal block with 1% lidocaine is commonly used for transrectal prostate biopsy. Although 10 mL of 1% lidocaine is commonly used, the appropriate dosage of 1% lidocaine has not been studied. Our hospital routinely uses two different doses (5 or 10 mL) of 1% lidocaine for caudal block for transrectal prostate biopsy. Herein, we retrospectively evaluated the efficacy and safety of both doses of 1% lidocaine. Methods. This retrospective study included 869 patients who underwent transrectal prostate biopsy with caudal block at our hospital. The amount of 1% lidocaine was determined by the day of the week on which the biopsy was performed, and the patient voluntarily chose the day of the biopsy, unaware of the dose of 1% lidocaine used on that day. Pain, anal sphincter tonus, cancer diagnosis rate, and early complications were compared. Results. In total, 466 and 403 patients received 5 and 10 mL of 1% lidocaine for a caudal block, respectively. After propensity-score matching for patient characteristics, each group contained 395 patients. The pain score, anal sphincter tonus score, or prostate cancer diagnosis rate were not significantly different between the two groups. However, rectal bleeding was significantly more frequent and severe in the 10-mL than the 5-mL group (p=0.018 and p=0.0036, respectively). The incidence of other complications was not significantly different between the groups. Conclusions. Our results suggest that 5 mL of 1% lidocaine may be more suitable than 10 mL for caudal block during transrectal prostate biopsy.

show abstract

Transrectal ultrasound-guided prostate needle biopsy remains a safe method in confirming a prostate cancer diagnosis: a multicentre Australian analysis of infection rates

Cited by 6 publications

References 33 publications

Comparison of ciprofloxacin versus fosfomycin versus fosfomycin plus trimethoprim/sulfamethoxazole for preventing infections after transrectal prostate biopsy

Comparison of ciprofloxacin versus fosfomycin versus fosfomycin plus trimethoprim/sulfamethoxazole for preventing infections after transrectal prostate biopsy

Analysis of risk factors for infection after transrectal ultrasound-guided prostate biopsy and analysis of the value of preoperative prophylactic antimicrobial use

Lower Dose of 5 mL of 1% Lidocaine is More Suitable than the Conventional 10 mL for Caudal Block in Transrectal Prostate Biopsy: A Retrospective Cohort Study

Contact Info

Product

Resources

About