1198 REDUCED RATE OF INFECTIVE COMPLICATIONS AFTER INITIAL PROSTATE BIOPSY USING A UNIFORMED PRE-BIOPSY PROTOCOL: SINGLE INSTITUTION EXPERIENCE WITH 3,194 PATIENTS

You have accessJournal of UrologyProstate Cancer: Detection and Screening1 Apr 20111198 REDUCED RATE OF INFECTIVE COMPLICATIONS AFTER INITIAL PROSTATE BIOPSY USING A UNIFORMED PRE-BIOPSY PROTOCOL: SINGLE INSTITUTION EXPERIENCE WITH 3,194 PATIENTS Liyan Zhuang, Lauren Collins, Laura Peters, Bruce Blank, and Mark Garzotto Liyan ZhuangLiyan Zhuang Portland, OR More articles by this author , Lauren CollinsLauren Collins Portland, OR More articles by this author , Laura PetersLaura Peters Portland, OR More articles by this author , Bruce BlankBruce Blank Portland, OR More articles by this author , and Mark GarzottoMark Garzotto Portland, OR More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.833AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES A recent population-based study demonstrated an increasing frequency of infectious complications after prostate biopsy procedures with hospitalization rates approaching 5% (Nguyen et al. J Urol 2010). However it is unclear whether this effect is due solely to bacterial resistance and whether pre-procedural or technical modifications can mitigate complication rates. Thus, we sought to review the safety results at our institution where a uniformed pre-biopsy protocol has been in place for nearly two decades. METHODS The records from 3,194 unique patients in the Portland Veterans Affairs Medical Center (VAMC) database who underwent transrectal ultrasound (TRUS) with initial prostate biopsy were reviewed. All patients had a normal urinalysis and no signs of prostatitis. All patients received a cleansing enema and antibiotic prophylaxis consistent with 2010 AUA guidelines, most commonly a one-day course of an oral flouroquinolone. All patients received a post-procedure telephone call within 2 weeks and any adverse effects were recorded. Rate of complications were assessed for the entire group and by study period (pre-2001 vs. 2001–2005 vs 2006–2010). RESULTS Of all 3,194 patients who underwent the initial TRUS biopsy, complications occurred in 27 pts. (0.85%). These were classified as infectious in 18 pts (0.56%), clinically significant hematuria in 4 pts. (0.16%) and urinary retention in 5 pts. (0.13%). Hospital admission was required in 11 pts. (0.34%). There was a slight trend towards increased infectious complications in the two groups undergoing biopsy between 2001–2010 as compared to the pre-2001 group. CONCLUSIONS Due to the emergence of antimicrobial-resistant organisms pre-procedure strategies that offset infectious complications are desperately needed. In our experience, strict adherence with a uniformed pre-procedure regimen resulted in a reduced rate of infections and hospitalizations as compared to historical controls. Based on these findings, the impact of ancillary measures prior to prostate biopsy procedures as a means of infection control is worthy of further study. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185 Issue 4S April 2011 Page: e481 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.Metrics Author Information Liyan Zhuang Portland, OR More articles by this author Lauren Collins Portland, OR More articles by this author Laura Peters Portland, OR More articles by this author Bruce Blank Portland, OR More articles by this author Mark Garzotto Portland, OR More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...