Delayed life-threatening hemorrhage after transrectal prostate needle biopsy

Petroski, R A; Griewe, Greg L.; Schenkman, Noah S.

doi:10.1038/sj.pcan.4500645

Cited by 12 publications

(11 citation statements)

References 19 publications

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“…Although rare, prostate biopsy can potentially have fatal outcome. A few cases (mainly case reports) of profuse potentially life‐threatening rectal haemorrhage have been reported in the literature; some have required different types of interventions but, to the best of our knowledge, there are no reported fatalities from rectal bleeding [5–14]. Fatal cases described in the literature (Table 1) were mainly caused by septicaemia; either anaerobic or as a result of Escherichia coli [3,15–23].…”

Section: Introductionmentioning

confidence: 99%

No excess mortality after prostate biopsy: results from the European Randomized Study of Screening for Prostate Cancer

Carlsson

Holmberg²,

Moss

et al. 2010

BJU International

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• Incidence rate ratios (RR) and statistical significance were evaluated using Poisson regression analyses, adjusting for age, total PSA level, screening centre and whether a biopsy indication was present, or whether a biopsy was actually performed or not. RESULTS• There was no statistically significant difference in cumulative 120-day other cause mortality between the two groups of men: 0.24% (95% CI, 0.17-0.34) for screening-positive men vs 0.24% (95% CI, 0.20-0.30) for screening-negative men ( P = 0.96). This implied no excess mortality for screening-positive men.• Screening-positive men who were not biopsied ( n = 1238) had a more than fourfold risk of other cause mortality during the first 120 days compared to screening-negative men: RR, 4.52 (95% CI, 2.63-7.74) ( P < 0.001), adjusted for age, whereas men who were actually biopsied ( n = 11 721) had half the risk: RR, 0.41 (95% CI, 0.23-0.73) ( P = 0.002), adjusted for age.• Only 14/31 (45%) of the screeningpositive men who died within 120 days were biopsied and none died as an obvious complication to the biopsy. CONCLUSION• Prostate biopsy is not associated with excess mortality and fatal complications appear to be very rare. PATIENTS AND METHODS• From three centres in the ERSPC (Finland, The Netherlands and Sweden) 50 194 screened men aged 50.2-78.4 years were prospectively followed. A cohort of 12 959 first-time screening-positive men (i.e. with biopsy indication) was compared with another cohort of 37 235 first-time screening-negative men.• Overall mortality rates (i.e. other cause than prostate cancer mortality) were calculated and the 120-day and 1-year cumulative mortality were calculated by the Kaplan-Meier method, with a log-rank test for statistical significance.

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Section: Introductionmentioning

confidence: 99%

No excess mortality after prostate biopsy: results from the European Randomized Study of Screening for Prostate Cancer

Carlsson

Holmberg²,

Moss

et al. 2010

BJU International

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“…Most symptomatic rectal bleedings are easily stopped by digital or balloon rectal compression, or using a rectal sponge too (7). Instead, significant hemorrhages are very rare and they require transfusions and surgical or radiointerventistic procedures (8). We report the second case in literature of a very large hematoma extending from the pelvis into the retroperitoneal space (2).…”

Section: Discussionmentioning

confidence: 99%

Rare Complication after a Transrectal Ultrasound Guided Prostate Biopsy: A Giant Retroperitoneal Hematoma

Chiancone

Mirone

Fedelini³

et al. 2015

Urologia

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Common complications related to transrectal ultrasound (TRUS) guided prostatic needle biopsy are hematuria, hematospermia, and hematochezia. To the best of our knowledge, we report the second case of a very large hematoma extending from the pelvis into the retroperitoneal space in literature.A 66-year-old man with a serum prostate-specific antigen (PSA) of 5.4 ng/ml was admitted to our department for a TRUS-guided prostatic needle biopsy. Laboratory values on the day before biopsy, including coagulation studies, were all normal. The patients did not take any anticoagulant drugs. No immediate complications were encountered. Nevertheless, 7 hours after the biopsy, the patient reached our emergency department with severe diffuse abdominal pain, hypotension, tachycardia, and confusional state. He underwent an ultrasonography and then a computed tomography (CT) scan that showed "a blood collection in the pelvis that extending to the lower pole of left kidney associated with a focus of active contrast extravasation, indicating active ongoing prostate bleeding." Consequently, he underwent a diagnostic angiography that showed no more contrast extravasation, without the need of embolization. Management of hematoma has been conservative and hematoma was completely reabsorbed 4 months later.

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“…Usually, hemorrhage can be shown along with renal agenesis or abnormal urogenital structures ( 44 ). Hemorrhage can occur due to a multitude of reasons, including post-transrectal prostate needle biopsy ( 77 ).…”

Section: Etiologymentioning

confidence: 99%

Etiologic classification, evaluation, and management of hematospermia

Suh¹,

Gandhi²,

Joshi³

et al. 2017

Transl. Androl. Urol.

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Hematospermia is defined by the presence of blood in the semen typically occurring in men younger than 40 years of age. Symptoms can occur due to a multitude of reasons, but are usually benign and self-limiting, requiring no additional treatment or evaluation. Despite this, the condition often impairs quality of life due to associated anxiety and must be taken seriously by the patient and the physician, particularly if recurrent, refractory, and painful. The etiology of hematospermia can be classified into inflammatory, infectious, lithiasis, cystic, obstructive, tumoral, vascular, traumatic, iatrogenic, and systemic origin. Alternatively, it can also be divided into subcategories based on anatomical origins such as prostate, bladder, spermatic cord, seminal vesicles, or epididymis. A complete history and physician examination, laboratory testing, and a variety of invasive and non-invasive imaging and instrumentation modalities can help to identify and treat the underlying pathology promptly.

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Delayed life-threatening hemorrhage after transrectal prostate needle biopsy

Cited by 12 publications

References 19 publications

No excess mortality after prostate biopsy: results from the European Randomized Study of Screening for Prostate Cancer

No excess mortality after prostate biopsy: results from the European Randomized Study of Screening for Prostate Cancer

Rare Complication after a Transrectal Ultrasound Guided Prostate Biopsy: A Giant Retroperitoneal Hematoma

Etiologic classification, evaluation, and management of hematospermia

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