Does Washing the Biopsy Needle with Povidone-Iodine Have an Effect on Infection Rates after Transrectal Prostate Needle Biopsy?

Abstract

Purpose: To determine the effect of washing the biopsy needle with povidone-iodine solution on infection rates after transrectal ultrasonography-guided prostate biopsy. Patients and Methods: 180 patients with transrectal prostate biopsy were included. Infection was excluded with midstream urine culture before biopsy, and patients were divided into two groups. In group 1 (n = 84), the needle was washed with povidone-iodine after each material reception during biopsy, and in group 2 (n = 96), it was not. At day 3 and 2 weeks after the biopsy, patients were checked. On day 3, midstream urine was cultured and patients were checked for fever, hematuria, rectal hemorrhagia, hematospermia and urinary retention. Also, the effect of rectal preparation on infection rate was evaluated. Results: There was no significant difference between the patients’ ages, PSA levels and prostate volumes. In total, 11 patients (6.1%; 4 from group 1 and 7 from group 2) developed infectious complications. There was no statistically significant difference between the groups. Fever, asymptomatic bacteriuria and urinary system infection rates were also not statistically different between the groups. The most frequent complication was hematuria with 83 cases (46.1%), but they did not need hospitalization and no patient had acute urinary obstruction. Conclusions: Washing the biopsy needle with povidone-iodine did not have an effect on the infection rates. Antibiotic prophylaxis and cleaning the biopsy equipment is adequate for low infection rates.

Does Leaving the Biopsy Needle in Povidone-Iodine Solution Reduce Infective Complications after Biopsy?

“…The results of the study reported that no difference was found between the povidone-iodine group and control group in terms of infective complications [28]. The results obtained in that study do not comply with our study results.…”

Decrease in Infection Rate Following Use of Povidone-Iodine During Transrectal Ultrasound Guided Biopsy of the Prostate: A Double Blind Randomized Clinical Trial

“…There are two older studies that are in agreement with our study (10, 13). A reverse result was reported by Koc et al (12). They enrolled 180 patients and used a needle that was washed with povidone-iodine for the povidone-iodine prescribed group.…”

“…Antibiotic premedication is used routinely to decrease this complication (2, 3, 4), but despite the use of antibiotics, infection develops in many patients with various degrees, from pyuria without clinical symptoms to life-threatening septicemia (5, 6, 7). Different additional methods have been studied for reducing the rate of infection following TRUS guided biopsy including the use of cleansing enema before the procedure (8, 9, 10, 11, 12, 13, 14, 15). However, the results are different.…”

Febrile Infection in Post-Prostate Biopsy: Results of a Ten-Year Single-Institution Study in South Taiwan

“…Taylor et al showed that targeted antimicrobial prophylaxis based on rectal swab cultures may reduce the incidence of post-operative infectious complications and cost of care in patients undergoing TRUS-guided prostate biopsy [22]. In contrast, Koc et al reported that in a randomized controlled trial of 180 patients, washing of the biopsy needle with povidone-iodine solution did not reduce the rate of infection after transrectal needle biopsy of the prostate [23]. Bruyere et al, in a prospective cohort of 353 patients, reported that the routine bacterial culture of urine before prostate biopsy was not useful for antibiotic prophylaxis [24].…”