Is repeat prostate biopsy associated with a greater risk of hospitalization? Data from SEER-Medicare.
OBJECTIVE
We recently reported an increasing risk over time of hospitalization among Medicare participants after undergoing an initial prostate biopsy. Less is known about the relative risks of repeat prostate biopsies, which are frequently performed in prostate cancer screening and in active surveillance programs. We determined whether repeat biopsies are associated with an increased risk of hospitalization compared to the initial biopsy.


METHODS
Using SEER (Surveillance, Epidemiology and End Results)-Medicare linked data from 1991 to 2007 we identified 13,883 men who underwent a single prostate biopsy and 3,640 who had multiple biopsies. The 30-day hospitalization rates were compared between these groups, and with a randomly selected control population of 134,977. ICD-9 codes were then used to examine the frequency of serious infectious and noninfectious urological complications as the primary diagnosis for hospital admissions.


RESULTS
Initial and repeat biopsies were associated with a significantly increased risk of hospitalization within a 30-day period compared to randomly selected controls (p <0.0001). However, the repeat biopsy session was not associated with a greater risk of infectious (OR 0.81, 95% 0.49-1.32, p = 0.39) or serious noninfectious urological complications (OR 0.94, 95% CI 0.54-1.62, p = 0.82) compared to the initial biopsy.


CONCLUSIONS
Each biopsy was associated with a significant risk of complications compared to randomly selected controls. However, the repeat biopsy procedure itself was not associated with a greater risk of serious complications requiring hospital admission compared to the initial biopsy.
Department of Urology, New York University, New York, New York 10016, USA. stacyloeb@gmail.com
Stacy
S
Loeb
H Ballentine
HB
Carter
Sonja I
SI
Berndt
Winnie
W
Ricker
Edward M
EM
Schaeffer
D000368:Aged; D001707:Biopsy, Needle / Q000379:methods*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D006278:Medicare; D011467:Prostate / Q000473:pathology*; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D018426:SEER Program; D015996:Survival Rate / Q000639:trends; D014481:United States / Q000453:epidemiology