Presentation Authors: Giorgio Napodano, Tommaso Realfonso, Raffaele Baio, Giovanni Molisso, Maria Addesso, Roberto Sanseverino*, Nocera Inferiore, Italy
Introduction: Prostate biospy is the gold standard procedure to diagnose prostate cancer. The technique is usually performed under transrectal ultrasound (TRUS) guidance with transrectal or transperineal approach. Every year more than 1 milion pof procedure are realized in Europe. Complication rate is quite low; however fearsome infectious complications are increasing. We have retrospectively evaluated complication rate in our database and we have analyzed predictive factor of complications
Methods: From database of our institution we have evaluated complications of patients undergone transrectal random prostate biopsy for suspicion of prostate cancer. Complications were classified as bleeding more than 3 days after biopsy (hematuria, hematospermia, rectal bleeding), infection defined as fever more than 38Â°C, acute urinary retention (RUA). Hospitalization due to complication was ha salso been recorded. We have correlated every complication with age, prostate volume, PSA, PSAD, BMI, number of cores, cancer detection, diabetes mellitus, previous urinary or genital infection, BPCO, previous urological surgery, previous or concomitant tumor. Statistical analysis was performed using Chi square test, Mann Whitney, logistic regression test, as appropriate (SPSS 19).
Results: Data on 2.106 patients were collected. Patients characteristics are reported in table 1. Complications occurred in 6.4% of the patients (table 2). Multivariate analysis revealed correlation only for infection with previous history of urinary or genital infection (p0.001, OR 0.012 - CI 0.001-0.162) (table 3). A minority of patients (15 out of 2.106 0.7%) required hospitalization because of complications (11 for infection, 2 for hematuria, 1 for rectal bleeding, 1 for AUR). However 11.2% (15 of 134) of patients with complicatons needed hospital admisison. Previous urinary or genital infection was the only factor associated with hospitalization (p0.001 - 0.005 0.000-0.125).
Conclusions: Transrectal random prostate biopsy is a common and safe procedure. Complications rate is generally low (6.4%); hematospermia is more frequent complication (4.7%). Hospitalization is rarely needed (0.7%). However fearsome and lifethreatening infectious complications are main causes of hospital admission.