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


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 <24 h, and one (0.1%) with a transient ischaemia attack 1 day after biopsy. • Patients with urosepsis had an average hospitalization of 5 days, and 75% carried quinolone-resistant Escherichia coli organisms. • All patients with urinary retention had catheters removed within 10 days. No patients with haematuria required a blood transfusion. • No demographic or biopsy variables were particularly associated with development of a post-procedure complication.


CONCLUSIONS
• In this large contemporary series of TRUS PNBx, we observed a 2.5% rate of major complications requiring hospital admission or an ED visit. • No clinical or biopsy variables were directly associated with development of complications. • These data may be valuable when counselling patients before biopsy.
Division of Urology, Penn State Milton S. Hershey Medical Center, Hershey, PA 17033-0850, USA.
G Igor
GI
Pinkhasov
Yu-Kuan
YK
Lin
Ricardo
R
Palmerola
Paul
P
Smith
Frank
F
Mahon
Matthew G
MG
Kaag
J Edward
JE
Dagen
Lewis E
LE
Harpster
Carl T
CT
Reese
Jay D
JD
Raman
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000890:Anti-Infective Agents / Q000627:therapeutic use; D001707:Biopsy, Needle / Q000009:adverse effects*; D002939:Ciprofloxacin / Q000627:therapeutic use; D004630:Emergencies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D006417:Hematuria / Q000209:etiology / Q000628:therapy; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D002546:Ischemic Attack, Transient / Q000209:etiology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011467:Prostate / Q000473:pathology*; D011471:Prostatic Neoplasms / Q000473:pathology*; D018805:Sepsis / Q000209:etiology / Q000628:therapy; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use; D018084:Ultrasonography, Interventional / Q000009:adverse effects; D016055:Urinary Retention / Q000209:etiology / Q000628:therapy; D014552:Urinary Tract Infections / Q000209:etiology / Q000628:therapy
D000890:Anti-Infective Agents; D002939:Ciprofloxacin; D015662:Trimethoprim, Sulfamethoxazole Drug Combination