title: Bisacodyl rectal preparation can decrease infectious complications of transrectal ultrasound-guided prostate biopsy.
abstract: OBJECTIVE
  To assess whether rectal preparation before transrectal ultrasound (TRUS)-guided prostate biopsy could decrease the rate of infectious complications and to find any possible risk factors affecting the development of complications.
  
  
  METHODS
  This retrospective study included 879 cases of TRUS-guided prostate biopsy. All patients received antibiotic prophylaxis with levofloxacin or cefixime orally before biopsy and continually for 7 days after. A total of 456 patients received bisacodyl rectal preparation the night before or on the morning of the biopsy, and 423 did not. Major complications were defined as serious side effects requiring additional treatment. Infectious complications were classified as sepsis, fever (greater than 38 degrees C) without sepsis, and other clinical infection. We evaluated whether rectal preparation before biopsy could decrease infectious complications. Other potential risk factors were also investigated.
  
  
  RESULTS
  Major complications developed in 47 cases (5.3%), including 1 vasovagal episode, 10 cases of urinary retention, and 46 infectious complications, of which 19 were sepsis and 11 fever without sepsis. Among the potential risk factors, the number of biopsy cores and use of a rectal preparation were statistically significant risk factors influencing the development of infectious complications in multiple logistic regression analysis (P = 0.038 and P = 0.000, respectively).
  
  
  CONCLUSIONS
  The number of biopsy cores and prebiopsy rectal preparation use were statistically significant risk factors for infectious complications after prostate biopsy in our study. Thus, we recommend a rectal preparation before prostate biopsy to minimize the risk of infectious complications.
authors.affiliation: Department of Urology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea.
authors.forename: Seong Soo
authors.initials: SS
authors.lastname: Jeon
authors.forename: Seung-Hyo
authors.initials: SH
authors.lastname: Woo
authors.forename: Ji-Hwan
authors.initials: JH
authors.lastname: Hyun
authors.forename: Han Yong
authors.initials: HY
authors.lastname: Choi
authors.forename: Soo Eung
authors.initials: SE
authors.lastname: Chai
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis; D000284:Administration, Oral; D000285:Administration, Rectal; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019072:Antibiotic Prophylaxis; D001424:Bacterial Infections / Q000209:etiology / Q000517:prevention & control*; D014408:Biomarkers, Tumor / Q000032:analysis; D001707:Biopsy, Needle / Q000009:adverse effects* / Q000379:methods*; D001726:Bisacodyl / Q000008:administration & dosage*; D020682:Cefixime / Q000008:administration & dosage; D004823:Epididymitis / Q000209:etiology; D006801:Humans; D064704:Levofloxacin; D008297:Male; D008875:Middle Aged; D015242:Ofloxacin / Q000008:administration & dosage; D011467:Prostate / Q000000981:diagnostic imaging* / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000032:analysis; D011471:Prostatic Neoplasms / Q000175:diagnosis; D011472:Prostatitis / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D018084:Ultrasonography, Interventional
chemical_list: D014408:Biomarkers, Tumor; D001726:Bisacodyl; D064704:Levofloxacin; D020682:Cefixime; D015242:Ofloxacin; D017430:Prostate-Specific Antigen