Incidence of sepsis following transrectal ultrasound guided prostate biopsy at a tertiary-care medical center in Lebanon

Abstract

Background Urosepsis is a rare but life-threatening complication following transrectal ultrasound (TRUS) guided needle prostate biopsy. Despite the technological and pharmacological improvements, the problem of bacterial urosepsis after prostate biopsy remains. A strategy for preventing urosepsis following TRUS prostate biopsy in areas with high prevalence of resistant strains or patients presenting risk factors is lacking.Objectives The aim of this study was to assess the prevalence of urosepsis, as well its predictors, following TRUS guided needle biopsy of the prostate in a tertiary care medical center in Lebanon.Materials and Methods We carried out a retrospective study on all patients who underwent TRUS prostate biopsy at the American University of Beirut Medical Center between January 1, 2011 and June 31, 2013. Patients’ hospital charts were reviewed. Data collected included demographic information, pre-procedure disease specific information, as well as post-procedure information. Predictors of urosepsis following TRUS were assessed.Results In total, 265 patients were included in this study, where the prevalence of urosepsis following TRUS prostate biopsy was found to be 9.4%. The significant independent predictors of urosepsis were found to be: age with an OR=0.93 (95% CI: 0.88–1.00, p-value=0.03), and hypertension comorbidity with an OR=3.25 (95% CI: 1.19–8.85, p-value=0.02).Conclusion We found a high prevalence of urosepsis among patients who have undergone TRUS prostate biopsy, and identified two significant risk factors. The results of this study highlight the importance of implementing strategies for prevention of urosepsis following TRUS prostate biopsy.

Comparisons of cancer detection rate and complications between transrectal and transperineal prostate biopsy approaches - a single center preliminary study

“…Therefore, the hospitalization rate of the patients in the TP group (0%) was obviously lower than that in the TR group (7.4%) (Table 2). In addition, median (25–75% quartiles) of VAS scores of the patients in the TP and TR groups was 3 [3, 4] and 4 [3–5], respectively, but there was no statistically significant difference between these two groups ( p = 0.085 ) (Table 3) (Fig. 6).…”

“…hematuria, hematospermia, rectal bleeding, and acute urine retention) to severe complications (e.g. anemia and syncope) [3]. Approximately 4 to 5% of the patients who undergo this procedure require hospital admission due to infection-related complications (ranging from bacteriuria to sepsis) [4, 5].…”

<p>Retrospective Study of the Etiology and Risk Factors of Systemic Inflammatory Response Syndrome After Systematic Transrectal Ultrasound-Guided Prostate Biopsy</p>

“…Currently, some studies indicate that age, BMI ≥ 25 kg/m 2 , diabetes mellitus, preoperative catheter, prostate volume, multiple punctures, history of hypertension, history of antiplatelet drugs, preoperative antibiotics and clean perfusion are risk factors for infection after TRUS-Bx. 12 , 21 – 25 However, some other scholars suggest that age, prostate volume, history of hypertension, PSA, fPSA/PSA, history of antiplatelet drugs, history of coronary heart disease and pathological results are not risk factors of infection after TURS-PB. 11 , 23 In this study, we found that age, hypertension, indwelling catheter, prostate volume, PSA, fPSA/PSA, pathological type and antibiotic use history were not independent risk factors of SIRS after TRUS-Bx.…”

Are Inflammatory Markers Useful in Predicting Urinary Tract Infection After Transrectal Ultrasound-Guided Biopsy of the Prostate?

“…In an earlier study of 265 patients, the prevalence of sepsis was found to be 9.4% [5]. Antibiotic prophylaxis minimizes life-threaten ing septic complications [5]. However, septic complica tions cannot be avoided completely.…”