title: Systematic review of complications of prostate biopsy.
abstract: BACKGROUND
  Prostate biopsy is commonly performed for cancer detection and management. The benefits and risks of prostate biopsy are germane to ongoing debates about prostate cancer screening and treatment.
  
  
  OBJECTIVE
  To perform a systematic review of complications from prostate biopsy.
  
  
  METHODS
  A literature search was performed using PubMed and Embase, supplemented with additional references. Articles were reviewed for data on the following complications: hematuria, rectal bleeding, hematospermia, infection, pain, lower urinary tract symptoms (LUTS), urinary retention, erectile dysfunction, and mortality.
  
  
  RESULTS
  After biopsy, hematuria and hematospermia are common but typically mild and self-limiting. Severe rectal bleeding is uncommon. Despite antimicrobial prophylaxis, infectious complications are increasing over time and are the most common reason for hospitalization after biopsy. Pain may occur at several stages of prostate biopsy and can be mitigated by anesthetic agents and anxiety-reduction techniques. Up to 25% of men have transient LUTS after biopsy, and <2% have frank urinary retention, with slightly higher rates reported after transperineal template biopsy. Biopsy-related mortality is rare.
  
  
  CONCLUSIONS
  Preparation for biopsy should include antimicrobial prophylaxis and pain management. Prostate biopsy is frequently associated with minor bleeding and urinary symptoms that usually do not require intervention. Infectious complications can be serious, requiring prompt management and continued work into preventative strategies.
authors.affiliation: Department of Urology, New York University, New York, NY, USA. Electronic address: stacyloeb@gmail.com.
authors.forename: Stacy
authors.initials: S
authors.lastname: Loeb
authors.forename: Annelies
authors.initials: A
authors.lastname: Vellekoop
authors.forename: Hashim U
authors.initials: HU
authors.lastname: Ahmed
authors.forename: James
authors.initials: J
authors.lastname: Catto
authors.forename: Mark
authors.initials: M
authors.lastname: Emberton
authors.forename: Robert
authors.initials: R
authors.lastname: Nam
authors.forename: Derek J
authors.initials: DJ
authors.lastname: Rosario
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Scattoni
authors.forename: Yair
authors.initials: Y
authors.lastname: Lotan
mesh_terms: D001424:Bacterial Infections / Q000209:etiology; D001707:Biopsy, Needle / Q000009:adverse effects*; D007172:Erectile Dysfunction / Q000209:etiology; D006801:Humans; D008297:Male; D010146:Pain / Q000209:etiology; D011467:Prostate / Q000473:pathology*
keywords: Biopsy; Bleeding; Complications; Infection; Mortality; Prostate