title: Safety and detailed patterns of morbidity of transrectal ultrasound guided needle biopsy of prostate in a urologist-led unit.
abstract: OBJECTIVE
  We prospectively evaluate the safety, morbidity and characteristics of complications for transrectal ultrasound guided needle biopsy of prostate carried out solely by urologists in a single unit. This will help to counsel patient prior to the biopsy.
  
  
  METHODS
  One hundred consecutive patients were recruited to complete questionnaires prospectively, 2 weeks and 3 months after TRUS and prostate biopsy. Haematospermia, haematuria and rectal bleeding characteristics were evaluated. Pain, analgesia requirement, infection and urinary retention rates were also assessed.
  
  
  RESULTS
  Ninety-two patients (92%) returned questionnaires 2 weeks and 63 patients (63%) three months after the biopsy. At 2 weeks questionnaire, 58 patients (63%) experienced haematuria and 9 patients (10%) for more than 1 week. Eighty-five percent of the 58 patients who had haematuria described it as mild and intermittent. Twenty-three (25%) patients experienced a rectal bleed and none for more than four days. Only 1 patient experienced clots with the rectal bleeding. Twelve (13%) patients had difficulty passing urine but the symptoms resolved by day four. Acute urinary retention did not occur. Thirty-five (38%) patients had some degree of discomfort and only one patient had pain for more than three days. Twenty-five (27%) patients took analgesia between 1 and 8 days (Mean 3 days). Two patients had a urinary tract infection despite prophylactic antibiotics. At three months, 4 patients (6%) had experienced secondary haematuria 3 weeks after the biopsy. Two patients experienced more rectal bleeding 2 weeks after the biopsy and 1 patient had residual discomfort 2 weeks after the procedure. Thirteen patients (21%) had haematospermia between day 6 and 56 (Mean 21 days).
  
  
  CONCLUSIONS
  Transrectal ultrasound guided biopsy of the prostate is generally well tolerated with minor pain and morbidity in our urologist-led service. Our data will assist counselling of patients prior to the procedure.
authors.affiliation: Department of Urology, Wexham Park Hospital, 8 Marloes Road, W8 5LJ, Slough, Berks, UK. georgeleeurology@yahoo.co.uk
authors.forename: George
authors.initials: G
authors.lastname: Lee
authors.forename: Kakahama
authors.initials: K
authors.lastname: Attar
authors.forename: Marc
authors.initials: M
authors.lastname: Laniado
authors.forename: Omer
authors.initials: O
authors.lastname: Karim
mesh_terms: D001707:Biopsy, Needle / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods*; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006417:Hematuria / Q000209:etiology; D006801:Humans; D008297:Male; D009017:Morbidity; D010146:Pain / Q000209:etiology; D011446:Prospective Studies; D011467:Prostate / Q000473:pathology*; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000473:pathology; D012002:Rectal Diseases / Q000209:etiology; D011795:Surveys and Questionnaires; D018084:Ultrasonography, Interventional / Q000379:methods*; D016055:Urinary Retention / Q000209:etiology; D014552:Urinary Tract Infections / Q000209:etiology; D014572:Urology / Q000295:instrumentation / Q000379:methods*