Adequate rectal preparation reduces hospital admission for urosepsis after transrectal ultrasound – guided prostate biopsy

Vol. 44 (x): 2018 June 7.[Ahead of print]

doi: 10.1590/S1677-5538.IBJU.2018.0181


ORIGINAL ARTICLE

Yu-Chen Chen 1, 2, Hao-Wei Chen 1, 2, Shu-Pin Huang 2, Hsin-Chin Yeh 3, Ching-Chia Li 2
1 Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; 2 Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; 3 Department of Urology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan

ABSTRACT

Objectives: Previous studies have compared infectious outcomes on the basis of whether rectal preparation was performed; however, they failed to evaluate the quality of each rectal preparation, which may have led to confounding results. This study aimed to com­pare hospitalizations for urosepsis within 1 month after transrectal ultrasound-guided prostate biopsy between patients with adequate and traditional rectal preparations.

Materials and Methods: Between January 2011 and December 2016, a total of 510 patients who underwent transrectal ultrasound – guided prostate biopsy at our in­stitutions and were orally administered prophylactic antibiotics (levofloxacin) were included. Two rectal preparations were performed: (1) adequate rectal preparation con­firmed by digital rectal examination and transrectal ultrasound (Group A, n = 310) and (2) traditional rectal preparation (Group B, n = 200). All patient characteristics were recorded. A logistic regression model was used to assess the effects of the two different rectal preparations on urosepsis, adjusted by patient characteristics.

Results: There were a total of three and nine hospitalizations for urosepsis in Groups A and B, respectively. Differences in the demographic data between the two groups were insignificant. Logistic regression showed that adequate rectal preparation before biopsy significantly decreased the risk for urosepsis after biopsy (adjusted odds ratio: 0.2; 95% confidence interval: 0.05 – 0.78; P = 0.021).

Conclusions: Adequate rectal preparation could significantly reduce hospitalizations for urosepsis within 1 month after transrectal ultrasound-guided prostate biopsy. The quality of rectal preparation should be evaluated before biopsy. If adequate rectal preparation is not achieved, postponing the biopsy and adjusting the rectal preparation regimen are suggested.

Keywords: Prostate; Prostatic Neoplasms; Ultrasound, High-Intensity Focused, Transrectal

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