Office cystoscopy and transrectal ultrasound-guided prostate biopsies pose minimal risk: prospective evaluation of 921 procedures.
OBJECTIVE
To examine the outcomes of 2 commonly performed urologic office procedures as a part of a process to align these with the Joint Commission standards to ensure patient safety. We determined whether cystoscopy and transrectal ultrasound-guided prostate biopsy performed in the office setting pose minimal risk to patients.


METHODS
An evaluation of urologic office procedures in the office clinic setting of an academic medical center was prospectively performed during 3 different periods to document patient and system events. The patients included those undergoing cystoscopy for workup of hematuria, history of bladder cancer, or other indicated conditions (n = 554) and patients undergoing transrectal ultrasound-guided prostate biopsy for suspicion of prostate cancer (n = 367). All consecutive patients were evaluated.


RESULTS
A total of 7 patient events (0.76%) and 101 system events (10.97%) were documented. The most significant adverse patient event was 1 case of acute bacterial prostatitis due to quinolone-resistant Escherichia coli. In most cases, the system event rate reflected a delay of >15 minutes in the initiation of the procedure. No patient experienced significant bleeding, perforation, or a major cardiopulmonary event.


CONCLUSIONS
The results of our study have shown that cystoscopy and transrectal ultrasound-guided prostate biopsy procedures performed in the office setting pose a minimal risk to patients. This information could be useful for hospitals and practices that are undergoing efforts to align their individual policies with current Joint Commission standards.
Department of Urology, University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA. surmatin@mdanderson.org
Surena F
SF
Matin
Thomas
T
Feeley
Debra
D
Kennamer
Joseph N
JN
Corriere
Michelle
M
Miles
Chuck
C
Kays
Howard
H
Green
Catherine E
CE
Craig
Colin P N
CP
Dinney
D001707:Biopsy, Needle / Q000379:methods*; D003558:Cystoscopy; D006801:Humans; D008297:Male; D009819:Office Visits; D011446:Prospective Studies; D011467:Prostate / Q000000981:diagnostic imaging* / Q000473:pathology*; D011785:Quality Assurance, Health Care; D012307:Risk Factors; D014463:Ultrasonography