Complications of transrectal ultrasound-guided systematic sextant biopsies of the prostate: evaluation of complication rates and risk factors within a population-based screening program

Rietbergen, John; Kruger, Arto E. Boeken; Kranse, Ries; Schröder, Fritz H.

doi:10.1016/s0090-4295(97)00100-3

Cited by 178 publications

(108 citation statements)

References 18 publications

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“…In our study, fever of 38.5ºC or higher was seen in 2.3% (n = 3) of 12-core biopsies. Fever has been reported in 6.6% of biopsies when an enema was not given before biopsy (19,20). In our study, enemas and antibiotics given before biopsy may have reduced the rate of fever.…”

Section: Commentssupporting

confidence: 48%

Retrospective study comparing six - and twelve-core prostate biopsy in detection of prostate cancer

Tobiume¹,

Yamada²,

Nakamura³

et al. 2008

Int. braz j urol.

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Objective: We compared the safety and efficacy of the 12-core biopsy with those of the conventional systematic 6-core biopsy with PSA levels between 4.1 and 20.0 ng/mL. Materials and Methods: This study included 428 patients who underwent a 6-core biopsy and 128 patients who underwent a 12-core biopsy. Biopsies were performed transrectally under ultrasound guidance. The 12-core biopsy scheme involved obtaining 6 far lateral cores. Results: For patients with PSA level between 4.1 and 10.1 ng/mL, 47 of the 265 patients who underwent 6-core biopsy and 32 of the 91 patients who underwent a12-core biopsy were diagnosed with prostate cancer (p = 0.0006). Among the patients with a PSA level between 10.1 and 20.0 ng/mL, 48 of 163 patients who underwent the 6-core biopsy and 16 of 37 patients who underwent the 12-core biopsy were diagnosed with prostate cancer (p = 0.0606). Three of the 95 patients who were diagnosed with prostate cancer through the 6-core biopsy and 12 of the 48 patients who were diagnosed through the 12-core biopsy had cancer located in the anterior apex. The 12-core biopsy increased the diagnostic rate in the apex (p = 0.001). No statistically significant differences were found in incidence of complications. Conclusion: We concluded that the 12-core biopsy is a safe and more effective procedure for increasing the diagnostic rate of prostate cancer than the 6-core biopsy in patients with PSA level between 4.1 and 10.0 ng/mL, and the most useful anatomical area to be added was found to be cores from the anterior apex.

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Section: Commentssupporting

confidence: 48%

Retrospective study comparing six - and twelve-core prostate biopsy in detection of prostate cancer

Tobiume¹,

Yamada²,

Nakamura³

et al. 2008

Int. braz j urol.

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“…6,22,25 The reason for the wide range in the incidence of hemospermia may be multifactorial. Many of the studies did not eliminate the patients who were not able to ejaculate.…”

Section: Discussionmentioning

confidence: 99%

“…In contrast, De la Taille et al 23 studied 303 patients with 21 core biopsy and reported 60% hemospermia. Reitbergen et al 25 demonstrated that hemospermia and hematuria were less frequently seen in men with prostate cancer in the biopsy specimen. This phenomenon remains uncer-tain and it is not reproduced in any other study.…”

Section: Discussionmentioning

confidence: 99%

Hemospermia following transrectal ultrasound-guided prostate biopsy: a prospective study

Manoharan

Ayyathurai

Nieder

et al. 2007

Prostate Cancer Prostatic Dis

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Hemospermia is known to be associated with transrectal ultrasound-guided prostate biopsy (TRUS-PB). The true incidence of hemospermia, its duration and implications are not well established. We performed a prospective observational study involving patients undergoing TRUS-PB for suspected prostate cancer at our institution. Sixty-three eligible men were included in the study. Most men (84%) undergoing TRUS-PB, who were able to ejaculate, experienced hemospermia, which was associated with some degree of anxiety. The mean duration of hemospermia was 3.5 (71.7) weeks. The number of ejaculations before the complete resolution of hemospermia was 8 (76.7). None of the clinical and pathological factors was a significant predictor of the duration of hemospermia. Patients should be adequately counseled before TRUS-PB to avoid undue anxiety and alterations in sexual activity.

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“…The hope that TRUS-guided biopsy would be painless and well tolerated has been not been realized [1±3, 6,8]. In our department, patient surveys [9] have shown that up to 30% of men report pain of any severity, and procedural pain is recognized as a signi®cant limitation to increasing the number of biopsies taken to minimize sampling error [10].…”

Section: Discussionmentioning

confidence: 99%

Pain after transrectal ultrasonography‐guided prostate biopsy: the advantages of periprostatic local anaesthesia

Seymour¹,

Perry²,

Lee-Elliot³

et al. 2001

BJU International

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Objective To prospectively evaluate the ef®cacy and safety of periprostatic local anaesthesia (LA) during prostatic biopsy guided by transrectal ultrasonography (TRUS), as 20±65% of men report moderate to severe pain, and there is anecdotal and published evidence that periprostatic anaesthesia improves patients' tolerance. Patients and methods In all, 157 patients were prospectively recruited and sequentially randomized to receive either LA or no anaesthesia. Sextant biopsies were taken in all men but some had more than six biopsies. All were asked to complete questionnaires immediately after TRUS-guided biopsy and for the subsequent week, giving pain scores and recording any morbidity, including symptoms of infection; analgesic use was also surveyed. Results Patients given LA had signi®cantly lower pain scores at the time of biopsy than those given no anaesthesia, with median (SD) pain scores of 1.53 (0.7) and 1.95 (0.65) (P<0.001), respectively. In addition, there was a trend towards less analgesic use by those given LA, although this was not statistically signi®cant. There was no difference in the amount of haematuria, haematochezia or haematospermia, or infection rate, between the groups. The additional cost and time of the procedure was minimal (£3.00 and 3 min/per patient, respectively). Conclusion Periprostatic LA in®ltration is a quick and simple procedure which signi®cantly improves immediate pain with no added morbidity; we strongly advocate its use to improve patient tolerance of TRUS-guided prostate biopsy.

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Complications of transrectal ultrasound-guided systematic sextant biopsies of the prostate: evaluation of complication rates and risk factors within a population-based screening program

Cited by 178 publications

References 18 publications

Retrospective study comparing six - and twelve-core prostate biopsy in detection of prostate cancer

Retrospective study comparing six - and twelve-core prostate biopsy in detection of prostate cancer

Hemospermia following transrectal ultrasound-guided prostate biopsy: a prospective study

Pain after transrectal ultrasonography‐guided prostate biopsy: the advantages of periprostatic local anaesthesia

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