title: In-bore transrectal MRI-guided prostate biopsies: Are there risk factors for complications?
abstract: OBJECTIVE
  To systematically analyze risk factors for complications of in-bore transrectal MRI-guided prostate biopsies (MRGB).
  
  
  METHODS
  90 patients, who were scheduled for MRGB were included for this study. Exclusion criteria were coagulation disorders, therapy with anticoagulant drugs, and acute infections of the urinary and the lower gastrointestinal tract. Directly after, one week and one year after the biopsy, we assessed biopsy related complications (e.g. hemorrhages or signs of prostatitis). Differences between patients with and without complications were analyzed regarding possible risk factors: age, prostate volume, number of taken samples, biopsy duration, biopsy of more than one lesion, diabetes, arterial hypertension, hemorrhoids, benign prostate hyperplasia, carcinoma or prostatitis (according to histopathological analysis), and lesion localization. Complications were classified according to the Clavien-Dindo classification.
  
  
  RESULTS
  We observed 15 grade I complications in 90 biopsies (16.7%) with slight hematuria in 9 cases (10%), minor vasovagal reactions in 4 cases (4.4%), and urinary retention and positioning-related facial dysesthesia in 1 case each (1.1%). One patient showed acute prostatitis requiring antibiotics as the only grade II complication (1.1%). There were no adverse events that occurred later than one week. Complications grade III or higher such as pelvic abscesses, urosepsis or severe hemorrhages were not seen. There were no significant associations between the assessed risk factors and biopsy-related complications.
  
  
  CONCLUSIONS
  In-bore transrectal MRI-guided prostate biopsies can be considered safe procedures in the diagnosis of prostate cancer with very low complication rates. There seem to be no risk factors for complications.
authors.affiliation: Department of Radiology, University of Bonn, Sigmund-Freud-Str 25, 53127 Bonn, Germany. Electronic address: michael.meier@ukb.uni-bonn.de.
authors.forename: Michael
authors.initials: M
authors.lastname: Meier-Schroers
authors.affiliation: Department of Radiology, University of Bonn, Sigmund-Freud-Str 25, 53127 Bonn, Germany. Electronic address: rami.homsi@ukb.uni-bonn.de.
authors.forename: Rami
authors.initials: R
authors.lastname: Homsi
authors.affiliation: Department of Radiology, University of Bonn, Sigmund-Freud-Str 25, 53127 Bonn, Germany. Electronic address: guido.kukuk@ukb.uni-bonn.de.
authors.forename: Guido
authors.initials: G
authors.lastname: Kukuk
authors.affiliation: Department of Radiology, University of Bonn, Sigmund-Freud-Str 25, 53127 Bonn, Germany. Electronic address: karsten.wolter@ukb.uni-bonn.de.
authors.forename: Karsten
authors.initials: K
authors.lastname: Wolter
authors.affiliation: Department of Radiology, University of Bonn, Sigmund-Freud-Str 25, 53127 Bonn, Germany. Electronic address: georges.decker@ukb.uni-bonn.de.
authors.forename: Georges
authors.initials: G
authors.lastname: Decker
authors.affiliation: Department of Radiology, University of Bonn, Sigmund-Freud-Str 25, 53127 Bonn, Germany. Electronic address: stefan.fischer@ukb.uni-bonn.de.
authors.forename: Stefan
authors.initials: S
authors.lastname: Fischer
authors.affiliation: Department of Radiology, University of Bonn, Sigmund-Freud-Str 25, 53127 Bonn, Germany. Electronic address: christian.marx@ukb.uni-bonn.de.
authors.forename: Christian
authors.initials: C
authors.lastname: Marx
authors.affiliation: Department of Radiology, University of Bonn, Sigmund-Freud-Str 25, 53127 Bonn, Germany. Electronic address: carsten.schmeel@ukb.uni-bonn.de.
authors.forename: Frederic Carsten
authors.initials: FC
authors.lastname: Schmeel
authors.affiliation: Department of Radiology, University of Bonn, Sigmund-Freud-Str 25, 53127 Bonn, Germany. Electronic address: wolfgang.block@ukb.uni-bonn.de.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Block
authors.affiliation: Department of Radiology, University of Bonn, Sigmund-Freud-Str 25, 53127 Bonn, Germany. Electronic address: sprinkart@uni-bonn.de.
authors.forename: Alois Martin
authors.initials: AM
authors.lastname: Sprinkart
authors.affiliation: Department of Radiology, University of Bonn, Sigmund-Freud-Str 25, 53127 Bonn, Germany. Electronic address: frank.traeber@ukb.uni-bonn.de.
authors.forename: Frank
authors.initials: F
authors.lastname: Traeber
authors.affiliation: Department of Radiology, University of Bonn, Sigmund-Freud-Str 25, 53127 Bonn, Germany. Electronic address: hans.schild@ukb.uni-bonn.de.
authors.forename: Hans Heinz
authors.initials: HH
authors.lastname: Schild
authors.affiliation: Department of Radiology, Neuroradiology, Sonography and Nuclear Medicine, Hospital of the Barmherzige Brüder Trier, Nordallee 1, 54292 Trier, Germany. Electronic address: w.willinek@bk-trier.de.
authors.forename: Winfried
authors.initials: W
authors.lastname: Willinek
mesh_terms: D000367:Age Factors; D000368:Aged; D002277:Carcinoma / Q000150:complications; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D038524:Diffusion Magnetic Resonance Imaging / Q000009:adverse effects; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006417:Hematuria / Q000209:etiology; D006484:Hemorrhoids / Q000150:complications; D006801:Humans; D006973:Hypertension / Q000150:complications; D007089:Image Enhancement / Q000379:methods; D061705:Image-Guided Biopsy / Q000009:adverse effects*; D008279:Magnetic Resonance Imaging / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010292:Paresthesia / Q000209:etiology; D056888:Patient Positioning / Q000009:adverse effects; D016684:Prone Position; D011467:Prostate / Q000473:pathology; D011470:Prostatic Hyperplasia / Q000150:complications; D011471:Prostatic Neoplasms / Q000175:diagnosis*; D011472:Prostatitis / Q000209:etiology; D012007:Rectum / Q000473:pathology; D012307:Risk Factors
keywords: Biopsy; Complications; MRI; Prostate; Risk factors