title: Transrectal-ultrasound prostatic biopsy preparation: rectal enema vs. mechanical bowel preparation.
abstract: BACKGROUND
  Transrectal prostate biopsy (TRUSbx) is the standard for the diagnosis of prostate cancer. Different bowel preparations are used for patients undergoing TRUSbx. The aim of our study was to compare two different bowel preparations for TRUSbx.
  
  
  METHODS
  From May 2012 and onwards, a selected group of men undergoing TRUS 12-core prostate biopsy were enrolled into a prospective database. Patients were randomized 1:1 to receive a rectal enema (Group A) the night before the procedure or polyethylene glycol 34.8 grams/4 liters of water the day before the procedure (Group B). A VAS scale to evaluate the patients' discomfort according to the two preparations was collected. The same antibiotic prophylaxis was performed in both groups. All complications were prospectively recorded and graded according to the Clavien Classification System (CCS).
  
  
  RESULTS
  A total of 198 patients were consecutively enrolled. Mean age was 67.5 ±7.9 years, mean body mass index (BMI) was 27.1 ±4.2 Kg/m(2), mean PSA value was 9.3 ±12.6 ng/ml and the mean prostatic volume was 60.6 ±29 ml. 97 patients were enrolled in Group A and 101 in Group B. Overall post-biopsy morbidity rate was 60%. No significant differences for low-grade and high-grade complications was observed between the two groups. Patients receiving the rectal enema presented with a significantly lower VAS score (3.1 ±1.1 vs. 5.9 ±1.7; p = 0.02).
  
  
  CONCLUSIONS
  Our study confirmed that a rectal enema should be considered as the standard bowel preparation in patients undergoing a TRUS biopsy; it is as effective as PEG and associated with less discomfort.
authors.affiliation: Ospedale Sant'Andrea, La Sapienza, Roma, Italia.
authors.forename: Cosimo
authors.initials: C
authors.lastname: De Nunzio
authors.affiliation: Ospedale Sant'Andrea, La Sapienza, Roma, Italia.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Lombardo
authors.affiliation: Ospedale Sant'Andrea, La Sapienza, Roma, Italia.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Presicce
authors.affiliation: Ospedale Sant'Andrea, La Sapienza, Roma, Italia.
authors.forename: Mariangela
authors.initials: M
authors.lastname: Bellangino
authors.affiliation: Policlinico Torvegata, Roma, Italia.
authors.forename: Enrico
authors.initials: E
authors.lastname: Finazzi Agro
authors.affiliation: Ospedale Sant'Andrea, La Sapienza, Roma, Italia.
authors.forename: Matteo Bonetto
authors.initials: MB
authors.lastname: Gambrosier
authors.affiliation: Ospedale Sant'Andrea, La Sapienza, Roma, Italia.
authors.forename: Alberto
authors.initials: A
authors.lastname: Trucchi
authors.affiliation: Ospedale Sant'Andrea, La Sapienza, Roma, Italia.
authors.forename: Stefano
authors.initials: S
authors.lastname: Petta
authors.affiliation: Ospedale Sant'Andrea, La Sapienza, Roma, Italia.
authors.forename: Andrea
authors.initials: A
authors.lastname: Tubaro
keywords: complications; polyethylene glycol; prostate biopsy; prostate cancer; rectal enema