title: Formalin disinfection of prostate biopsy needles may reduce post-biopsy infectious complications.
abstract: We sought to determine whether formalin disinfection of prostate biopsy needles between cores reduces post-biopsy urinary tract infections (UTIs).
  
  
  
  We reviewed a single-surgeon experience of transrectal prostate biopsies from 2010 to 2014. Biopsies were performed in either an operative suite, where 10% formalin was used to disinfect the needle tip between each biopsy core, or an outpatient clinic, where formalin was not used. Our primary outcome was post-biopsy UTI rates, defined as a positive urine culture within 30 days of biopsy. Infection severity was characterized by the need for admission. Patient demographics, prostate size, prior biopsies, prior UTIs, pre-biopsy antibiotics and cultures and post-biopsy cultures were analyzed. Logistic regression was used to assess predictors of post-biopsy UTIs. Statistical significance was defined as P<0.05.
  
  
  
  A total of 756 patients were included for analysis, including 253 who received formalin disinfection and 503 who did not. Of these, 32 patients (4.2%) experienced post-biopsy UTIs, with 8 requiring admission (all without formalin use). Infection rates were more than double in the group that did not receive formalin (5.2% vs 2.3%, P=0.085). More patients in the formalin group had undergone prior biopsies (73.9% vs 31.8%, P<0.001). On multivariable analysis, prior UTI (odds ratio (OR) 3.77, P=0.006) was a significant predictor for post-biopsy infection, whereas formalin disinfection trended towards a protective effect (OR 0.41, P=0.055).
  
  
  
  Infectious complications following prostate biopsy may be mitigated by the use of formalin disinfection of the biopsy needle between cores.
authors.affiliation: Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
authors.forename: N
authors.initials: N
authors.lastname: Singla
authors.affiliation: Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
authors.forename: J
authors.initials: J
authors.lastname: Walker
authors.affiliation: Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
authors.forename: S L
authors.initials: SL
authors.lastname: Woldu
authors.affiliation: Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
authors.forename: N M
authors.initials: NM
authors.lastname: Passoni
authors.affiliation: Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
authors.forename: K
authors.initials: K
authors.lastname: de la Fuente
authors.affiliation: Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
authors.forename: C G
authors.initials: CG
authors.lastname: Roehrborn
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001707:Biopsy, Needle / Q000009:adverse effects*; D004203:Disinfection; D005557:Formaldehyde / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011467:Prostate / Q000382:microbiology / Q000473:pathology; D011471:Prostatic Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000473:pathology; D014552:Urinary Tract Infections / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology
chemical_list: D000900:Anti-Bacterial Agents; D005557:Formaldehyde