title: Morbidity after transperineal prostate biopsy in 3000 patients undergoing 12 vs 18 vs more than 24 needle cores.
abstract: OBJECTIVE
  To evaluate clinical complications after transperineal prostate biopsy in patients undergoing 12 vs 18 vs more than 24 cores.
  
  
  METHODS
  From February 2002 to December 2012, 3000 patients (median age, 66 years) underwent transperineal prostate biopsy after an abnormal result on a digital rectal examination, prostate-specific antigen (PSA) level >10 ng/mL, PSA values between 4.1 and 10, 2.6 and 4, and <2.5 ng/mL with free/total PSA ≤25%, ≤20%, and ≤15%, respectively. Of these, 915 (30.5%), 1330 (48.5%), and 630 patients (21%) underwent 12, 18, and >24 needle cores under antibiotic prophylaxis. Prostate biopsy-related complications were evaluated within 15 to 20 days after the prostate biopsy. The number of patients who needed hospital admission or an emergency department visit (EDV) was recorded.
  
  
  RESULTS
  Prostate cancer was found in 1150 (38.3%) patients. Side effects after the biopsy occurred in 40.2% of the patients, and the complications were directly correlated with the number of needle cores: 31.5% with 12 cores, 41.8% with 18 cores, and 57.4% with >24 cores (P = .001). Overall hospital admission and EDV were 1.2% and 9.1% and occurred, respectively, in 1% and 6% (12 cores) vs 1.3% and 9.6% (18 cores) vs 1.6% and 14.4% (>24 cores) of the patients. The most frequent complication that needed hospital admission vs EDV was urinary tract infection (0.7%) vs acute urinary retention (6.7%), respectively. No patients developed sepsis.
  
  
  CONCLUSIONS
  Clinical complications after transperineal prostate biopsy occurred in 40.2% of the patients, but only 1.2% required hospital admission. The number of needle cores (12 vs 18 vs >24) significantly correlated with increased onset of side effects.
authors.affiliation: Urology Unit, Cannizzaro Hospital, Catania, Italy. piepepe@hotmail.com
authors.forename: Pietro
authors.initials: P
authors.lastname: Pepe
authors.forename: Francesco
authors.initials: F
authors.lastname: Aragona
mesh_terms: D000328:Adult; D000368:Aged; D019072:Antibiotic Prophylaxis; D001707:Biopsy, Needle / Q000009:adverse effects* / Q000379:methods; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D051516:Hemospermia / Q000209:etiology; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010502:Perineum; D011467:Prostate / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000473:pathology*; D012189:Retrospective Studies; D016055:Urinary Retention / Q000209:etiology; D014552:Urinary Tract Infections / Q000209:etiology
chemical_list: D017430:Prostate-Specific Antigen