Complications following prostate needle biopsy requiring hospital admission or emergency department visits – experience from 1000 consecutive cases

• Published in: BJU international 2012-08, Vol.110 (3), p.369-374
• Main Authors: Pinkhasov, G. Igor, Lin, Yu‐Kuan, Palmerola, Ricardo, Smith, Paul, Mahon, Frank, Kaag, Matthew G., Dagen, J. Edward, Harpster, Lewis E., Reese, Carl T., Raman, Jay D.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Anti-Infective Agents - therapeutic use; Bacterial diseases; Bacterial sepsis; Biological and medical sciences; Biopsy, Needle - adverse effects; Ciprofloxacin - therapeutic use; Emergencies; Emergency Service, Hospital - statistics & numerical data; haematuria; Hematuria - etiology; Hematuria - therapy; Hospitalization; Hospitalization - statistics & numerical data; Hospitals; Human bacterial diseases; Humans; infection; Infectious diseases; Ischemic Attack, Transient - etiology; Ischemic Attack, Transient - therapy; Male; Medical sciences; Middle Aged; modified Clavien classification; Nephrology. Urinary tract diseases; Older people; Patients; Prostate - pathology; prostate needle biopsy; Prostatic Neoplasms - pathology; sepsis; Sepsis - etiology; Sepsis - therapy; Trimethoprim, Sulfamethoxazole Drug Combination - therapeutic use; Ultrasonography, Interventional - adverse effects; urinary retention; Urinary Retention - etiology; Urinary Retention - therapy; Urinary system involvement in other diseases. Miscellaneous; Urinary Tract Infections - etiology; Urinary Tract Infections - therapy; Urinary tract. Prostate gland
• ISSN: 1464-4096; 1464-410X
• DOI: 10.1111/j.1464-410X.2011.10926.x

Study Type – Harms (cohort series) Level of Evidence 2b What's known on the subject? and What does the study add? Population‐based studies implicate an increased incidence of complications after prostate needle biopsy. Such information is essential for adequate patient counselling before the procedure. A limitation of population‐based studies is the absence of individual patient data to better characterize the nature of post‐biopsy complications. This study of 1000 consecutive patients treated at a single centre highlights hospital admissions as well as Emergency Department visits for patients after prostate needle biopsy. Importantly, it allows for characterization of specific complications, aetiologies, management and outcomes for affected patients. OBJECTIVE •  To review a contemporary cohort of patients undergoing a transrectal ultrasound‐guided prostate needle biopsy (TRUS PNBx) at a single centre to determine the incidence of major complications necessitating hospital admission or emergency department (ED) visits. PATIENTS AND METHODS •  The charts of 1000 consecutive patients undergoing TRUS PNBx were reviewed. •  All patients received peri‐procedural antibiotic prophylaxis with either ciprofloxacin or co‐trimoxazole. •  Hospital admission and ED visits within 30 days of the procedure were identified for indication, management and outcome. •  Patient comorbidities and biopsy characteristics were reviewed for association with complications. RESULTS •  Of the 1000 patients, 25 (2.5%) had post‐biopsy complications requiring hospital admission or an ED visit. •  Indications included twelve patients (1.2%) with urosepsis, eight (0.8%) with acute urinary retention requiring urethral catheterization, four (0.4%) with gross haematuria requiring bladder irrigation for