title: Commentary on "Is repeat prostate biopsy associated with a greater risk of hospitalization? Data from SEER-Medicare." Loeb S, Carter HB, Berndt SI, Ricker W, Schaeffer EM, Department of Urology, New York University, New York, NY. J Urol 2013; 189(3):867-70. [Epub 2012 Oct 9]. doi: 10.1016/j.juro.2012.10.005.
abstract: 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.
authors.forename: Scott
authors.initials: S
authors.lastname: Eggener
mesh_terms: D001707:Biopsy, Needle / Q000379:methods*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D006278:Medicare; D011467:Prostate / Q000473:pathology*; D011471:Prostatic Neoplasms / Q000175:diagnosis*; D018426:SEER Program