Acute prostatitis after prostate biopsy under ciprofloxacin prophylaxis with or without ornidazole and pre-biopsy enema: analysis of 3.479 prostate biopsy cases

Balaban, Muhsin; Özkaptan, Orkunt; Sevinc, Cuneyd; Boz, Mustafa; Horuz, Rahim; Kafkaslı, Alper; Cangüven, Önder

doi:10.1590/s1677-5538.ibju.2019.0257

Cited by 5 publications

(4 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…With great satisfaction, the International Brazilian Journal of Urology once again brings to our dear readers an assessment of prostate biopsy guided by ultrasound from a different perspective. In previous editions, new data about complications of the procedure ( 5 ) and evaluation of the pain pattern in different methods of sample acquisition ( 6 ) were presented. In this issue we bring you an article that discusses the mood disorders associated with biopsy and positive results.…”

Section: Commentmentioning

confidence: 99%

Editorial Comment: Anxiety and depression associated with a positive prostate biopsy result: A comparative, prospective cohort study

Diniz

2020

Int. braz j urol.

View full text Add to dashboard Cite

Developed in the 1970s, transrectal ultrasound of the prostate applied to biopsy of that organ started to be used more widely in the 1980s (1, 2). In that decade, the use of this technology among renowned teams allowed great knowledge to be acquired about prostate anatomy, the procedure and complications (3, 4). Much has been changed since then, devices have developed substantially, new imaging methods have been added, protocols and guidelines have been outlined for the proper use of this diagnostic tool. So, after more than 30 years of publications, the most skeptical of urologists would say that this science is exhausted, and no other paper could emerge on this topic. With great satisfaction, the International Brazilian Journal of Urology once again brings to our dear readers an assessment of prostate biopsy guided by ultrasound from a different perspective. In previous editions, new data about complications of the procedure (5) and evaluation of the pain pattern in different methods of sample acquisition (6) were presented. In this issue we bring you an article that discusses the mood disorders associated with biopsy and positive results. The wide access and use of screening methods, made part of our actions somewhat mythical. The lack of real understanding about PSA and all the taboos inherent to digital rectal examination, together are enough to create a fog of doubt and fear among men in the age group for screening. In other areas of oncology, where screening methods are possible, patients also face similar challenges before diagnosis; and once it is done, a storm of dubious thoughts sets in their minds and souls. Among women, confirmation of a breast cancer or a cervical and its treatment may impact on self-image and sexual concerns which may lead to mood disorders and worsening quality of life (7-10). Likewise, a positive diagnosis through colonoscopic screening for malignancies can bring countless questions to the patient who, without assertive information or even without adequate support, can develop anxiety or depression (11). In the present study Sefik et al. demonstrated that, before biopsy, levels of anxiety and depression measured were correlated with serum levels of PSA. Demonstrating one of the negative effects that a "simple blood test" could have on individuals. And they show us more: just after biopsy, those symptoms disappeared; this is related to the good practice adopted in that department, where the patient is well oriented on the technique of the procedure just before it (12). In Rio de Janeiro, Brazil, at the National Cancer Institute-INCa-a branch of the Urology Department, the Prostate Cancer Diagnosis Center-CDCP-welcomes referral patients from all over the state, whose biopsy was requested in primary care by a family and community physician or even by urologists serving in public settings. Understanding the burden of expectations related to that referral, our Center proposes a multi-professional approach to the patient and his family.

show abstract

Section: Commentmentioning

confidence: 99%

Editorial Comment: Anxiety and depression associated with a positive prostate biopsy result: A comparative, prospective cohort study

Diniz

2020

Int. braz j urol.

View full text Add to dashboard Cite

show abstract

“…Биопсия простаты -инвазивный метод диагностики, который можно выполнять как в условиях амбулатории, так и в стационаре. Согласно данным статистики к основным осложнениям этой процедуры относятся гематурия (65,8%), ухудшение симптомов нижних мочевыводящих путей (до 25%), урогенитальная инфекция (от 1,0 до 17,5%), в т. ч. острый простатит, абсцесс простаты, орхоэпидидимит и уросепсис [1,2]. Кокрановский анализ, проведенный в 2011 г., не выявил существенную разницу в развитии септических осложнении между одной и множественными дозами профилактического приема антибиотиков у пациентов с низким уровнем риска развития инфекционных осложнений [3].…”

Section: Introductionunclassified

Fosfomycin in antibiotic prophylaxis of infectious complications after biopsy of the prostate

et al. 2022

View full text Add to dashboard Cite

Introduction. Biopsy of prostate is a routine urologic procedure. More than 1 million biopsies are performed worldwide annually. The frequency of infectious-inflammatory complications remain high, despite the recommended antibiotic prophylaxis schemes.Aim. The evaluation of effectiveness and safety of combined antimicrobial prophylaxis: Fosfomycin and Fluoroquinolones of 3rd generation.Materials and methods. 80 patients underwent prostate biopsy in our study and were divided into 2 groups: the first group of 40 patients received routine prophylaxis: Levofloxacin 500 mg 6 hours before the biopsy and 500 mg per day during 4 days after biopsy. The second group of 40 patients, along with standard prophylaxis as in the first group, additionally after biopsy received Fosfomycin 3 gr single-shot.Results and discussion. In the first group, infectious and inflammatory complications occurred in 8 patients (20%). 12.5% of patients from the first group were hospitalized for paranteral antibiotic therapy. The average length of stay in hospital was 3.4 ± 1.45 days. In all cases, in the first group of patients, E. coli was detected, in 70% of cases fluoroquinolone-resistant strain of the bacterium was received. In the second group of patients now hospitalization was required. One patient out of forty (2.5%) from this group showed signs of urinary tract infection, which was not accompanied by an increase of body temperature, as well as changes in blood and urine tests.Conclusion. Our results show good effectiveness and safety of fosfomicin for antibiotic prophylaxis for transrectal prostate biopsy.

show abstract

“…With great relevance, the International Brazilian Journal of Urology brings to its readers important material that points us to the dreaded complication inherent in transrectal ultrasound-guided prostate biopsy (TRUS-Bx) and the role of antibiotic prophylaxis against prostatitis ( 1 ). In their results, the authors demonstrated that cleasing enema did not change the outcome when comparing the groups.…”

mentioning

confidence: 99%

Editorial Comment: Acute prostatitis after prostate biopsy under ciprofloxacin prophylaxis with or without ornidazole and pre-biopsy enema: analysis of 3.479 prostate biopsy cases

Diniz

2020

Int. braz j urol.

View full text Add to dashboard Cite

With great relevance, the International Brazilian Journal of Urology brings to its readers important material that points us to the dreaded complication inherent in transrectal ultrasound-guided prostate biopsy (TRUS-Bx) and the role of antibiotic prophylaxis against prostatitis (1). In their results, the authors demonstrated that cleasing enema did not change the outcome when comparing the groups. It has been reported a significantly lower rate of complications by administering glycerin or saline enema 1h before TRUS-Bx (2) although a randomized study has shown that the use of iodine-povidine solution would not have the potential to reduce the risk of prostatitis with statistical significance (3). It should be agreed that even if it does not make the procedure aseptic, local hygiene is part of good practices, with low cost and adequate tolerability. In our clinical routine, we provide the patient, at the time of the biopsy indication, a glycerin suppository to be introduced into the rectum the night before the procedure. Among the advantages of this tactic, the patient can arrive with the empty rectum the next morning, and still facilitate the introduction of the probe by additional lubrication performed also with transrectal 2% lidocaine jelly anestesia after patient's sedation. The number of samples collected and the diameter of the needle was also the subject of concern on the correlation with infection after TRUS-Bx. Authors used the 18G needle and harvesting of 10 fragments under local anesthesia. Although studies suggest sampling with 12 to 18 fragments (4), the latest UAE recommendations propose that at least eight systematic biopsies are recommended in prostates with a size of about 30 cc and ten to twelve core biopsies are recommended in larger prostates (5). Ultrasound-guided periprostatic block is recommended (6) and is not related with increase rates of prostatitis (7). Although bacterial resistance to ciprofloxacin is well reported (8-10), this drug still represents an affordable and effective option in the context of prostate biopsy prophylaxis against infections. As in our daily practice at the National Cancer Institute's Prostate Cancer Diagnostic Center, group 1 used ciprofloxacin for a total of four days. Statistical analysis have shown that addition of the second drug (ornidazole) did not significantly reduce the rate of prostatitis. In a public health scenario, this information is relevant as it allows us to save resources that could be used for other inputs. Also regarding the relevant results, the authors report us the increased incidence of acute prostatitis in those individuals who underwent multiple TRUS-Bx. This may be the outmost data brought in this paper. Realize how current this information is and why it should be highlighted: understanding that we are increasingly diagnosing individuals in the early stages of the disease and that management through active surveillance includes serial biopsies; when recommending subsequent procedures, the practitioner should be extremely alert to si...

show abstract

Acute prostatitis after prostate biopsy under ciprofloxacin prophylaxis with or without ornidazole and pre-biopsy enema: analysis of 3.479 prostate biopsy cases

Cited by 5 publications

References 31 publications

Editorial Comment: Anxiety and depression associated with a positive prostate biopsy result: A comparative, prospective cohort study

Editorial Comment: Anxiety and depression associated with a positive prostate biopsy result: A comparative, prospective cohort study

Fosfomycin in antibiotic prophylaxis of infectious complications after biopsy of the prostate

Editorial Comment: Acute prostatitis after prostate biopsy under ciprofloxacin prophylaxis with or without ornidazole and pre-biopsy enema: analysis of 3.479 prostate biopsy cases

Contact Info

Product

Resources

About