Reducing infectious complications after transrectal prostate needle biopsy using a disposable needle guide: is it possible?

Gürbüz, Cenk; Canat, Lütfi; Atış, Gökhan; Çaşkurlu, Turhan

doi:10.1590/s1677-55382011000100010

Cited by 8 publications

(6 citation statements)

References 19 publications

(10 reference statements)

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“…Tuncel et al [ 23 ] reported that the use of a disposable needle guide, compared to a reusable needle guide disinfected between patients, significantly reduced the number of fevers and urinary tract infections after biopsy [ 23 ]. These results were not supported by a later study by Gurbuz et al [ 24 ] who observed no difference. Both studies had similar antibiotic prophylaxis and disinfection regimes and it may be that the differences were due to technical differences in the model of needle guide used.…”

Section: Discussioncontrasting

confidence: 89%

Prevention of sepsis prior to prostate biopsy

2016

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PurposeUrosepsis is the most feared complication of transrectal prostate biopsy. The incidence may be increasing from <1% to 2%–3% in contemporary series. Historically, fluoroquinolones have been effective antibiotic prophylaxis to prevent infective complications but antibiotic resistance is increasing. The increase in antibiotic resistance may contribute to reported increases in urosepsis and hospitalization after transrectal biopsy. This article will review other methods clinicians may employ to reduce the incidence of infective complications after prostate biopsy.Materials and MethodsA systematic review of the literature was conducted using literature databases PubMed and Ovid MEDLINE in August 2015 in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) criteria.ResultsEffective strategies to reduce infective complications after transrectal prostate biopsy include augmented prophylaxis with other antibiotics, rectal swab culture directed antibiotic prophylaxis or a transperineal biopsy approach. Needle disinfection, minimizing the number of biopsy needles and rectal disinfectants may also be of use. These methods may be of particular utility in patients with risk factors for developing urosepsis such as recent antibiotic use and overseas travel.ConclusionsThe scientific literature describes various techniques designed to reduce infective complications caused by prostate biopsy. Clinicians should consider incorporating these novel techniques into their contemporary practice.

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Section: Discussioncontrasting

confidence: 89%

Prevention of sepsis prior to prostate biopsy

2016

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“… 24 However, a smaller prospective randomized study by Gurbuz et al found no difference in infectious outcomes. 25 …”

Section: Strategies For Preventing Pnb-related Infectionsmentioning

confidence: 99%

Strategies for prevention of ultrasound-guided prostate biopsy infections

Raman

2016

IDR

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Prostate cancer is the most common cancer in male patients and the second leading cause of cancer-related mortality in males. To confirm the diagnosis of prostate cancer, an ultrasound-guided needle biopsy is necessary to obtain prostate tissue sufficient for histologic analysis by pathologists. Ultrasound-guided prostate needle biopsy can be accomplished via a transperineal or transrectal approach. The latter biopsy technique involves placing an ultrasound probe into the rectum, visualizing the prostate located just anterior to it, and then obtaining 12–14 biopsies. Each biopsy core requires piercing of the rectal mucosa which can inherently contribute to infection. The increasing infectious risk of prostate needle biopsy requires refinement and re-evaluation of the process in which the technique is performed. Such processes include (but are not limited to) prebiopsy risk stratification, antibiotic prophylaxis, use of rectal preparations, and equipment processing. In the subsequent review, we highlight the current available information on different strategies to reduce the risk of infection following prostate needle biopsy.

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“…found that rectal cleansing with povidone-iodine can reduce infective complications after the biopsy,[ 36 ] while using disposable needle was not successful in diminishing it. [ 37 ] Studies about prebiopsy enema gave conflicting results. [ 38 39 ] Other studies gave a promising future for targeted prophylactic ABx.…”

Section: Discussionmentioning

confidence: 99%

Oral antibiotics in trans-rectal prostate biopsy and its efficacy to reduce infectious complications: Systematic review

Yaghi

Kehinde

2015

Urol Ann

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For the diagnosis of prostate cancer trans-rectal prostate biopsy (TRPB) is used commonly, the procedure is associated with infective complications. There is evidence that antibiotics (ABx) decrease infective events after TRPB, but different regimens are used. To systematically review different regimens of prophylactic oral ABx in TRPB. MEDLINE, EMBASE, clinical trials site, and Cochrane library were searched, experts were consulted for relevant studies. Randomized clinical trials conducted in the last 20 years, which investigated the different oral antibiotic regimens in TRPB, and compared their efficacy to reduce infectious complications were analyzed. Primary outcomes were bacteriuria, urinary tract infection (UTI), fever, bacteremia, and sepsis. Secondary outcomes were the hospitalization rate and the prevalence of ABx-resistant bacteria. Nine trials were eligible with 3012 patients. ABx prevented bacteriuria (3.5% vs. 9.88%), UTI (4.46% vs. 9.75%), and hospitalization (0.21% vs. 2.13%) significantly in comparison with placebo or no treatment. No significant difference was found in all the outcomes of the review between the single dose regimen and the 3 days. The single dose regimen was as effective as the multiple doses except in bacteriuria (6.75% vs. 3.25%), and the prevalence of ABx-resistant bacteria (1.57% vs. 0.27%). Quinolones reduced only UTI significantly in comparison with other ABx (chloramphenicol, trimethoprim-sulfamethoxazol). It is essential to prescribe prophylactic ABx in TRPB. No conclusive evidence could be claimed about the superiority of the multiple or the 3 days regimens to the single dose regimen. Unexpectedly, ABx-resistant bacteria were identified more often in the single dose cohorts.

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Reducing infectious complications after transrectal prostate needle biopsy using a disposable needle guide: is it possible?

Cited by 8 publications

References 19 publications

Prevention of sepsis prior to prostate biopsy

Prevention of sepsis prior to prostate biopsy

Strategies for prevention of ultrasound-guided prostate biopsy infections

Oral antibiotics in trans-rectal prostate biopsy and its efficacy to reduce infectious complications: Systematic review

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