Mp48-11 Prospective Randomized Controlled Study to Assess the Effect of Perineal Region Cleansing With Povidone Iodine Before Transrectal Needle Biopsy of the Prostate on Infectious Complications

Taher, Younis; Özen, Haluk; Akdoğan, Bülent; Ünal, Serhat; Doğan, Selami

doi:10.1016/j.juro.2015.02.1685

Cited by 3 publications

(3 citation statements)

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“…15,[23][24][25][26][27] The efficacy of perineal skin disinfection was confirmed regarding the suppression of post-PBx infectious complications. 28 Povidone-iodine disinfection prior to PBx was effective compared with post-PBx. 29 In three RCTs comparing transperineal to transrectal PBx, [30][31][32] in a total of 646 patients there were two (0.4%) post-PBx infectious complications after the transperineal approach and five (1.1%) after the transrectal approach (RR 0.45, 95% CI 0.10-1.97).…”

Section: Eau Guidelines: Interventions Other Than Paasmentioning

confidence: 97%

Prevention and management of infectious complications in prostate biopsy: A review

Shigemura

Fujisawa

2021

Int J of Urology

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Prostate biopsies are common procedures for urologists, performed in order to detect and diagnose prostate cancer. Procedures continue to evolve, for instance, recently there has been an increase in the use of the transperineal approach, and the emergence of antibiotic-resistant bacteria has become a challenge. This review examines the recent prostate biopsy literature as well as the guidelines of three urological associations. We review the recent literature, including our own recent studies, and the Japanese Urological Association, European Association of Urology and American Urological Association guidelines, and summarize the current recommendations regarding the prevention of infectious complications that can occur after prostate biopsy, including the use of antimicrobial agents, and the management and treatment of such complications. Current recommendations include single-dose or 1-day use of oral quinolones for infection control, along with consideration of high-risk patients with diabetes, steroid use, large prostates, or high residual urine volume for instance. Targeted therapies based on the results of rectal swabs carried out prior to transrectal prostate biopsy, which can provide better inhibitory data with regard to post-prostate biopsy infectious complications, can also be considered. In conclusion, oral quinolones for low-risk patients and targeted therapies for high-risk patients are recommended when using a transrectal approach to prostate biopsy, and oral quinolones are recommended when using a transperineal approach. Further randomized controlled trials are necessary to draw more definitive conclusions.

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Section: Eau Guidelines: Interventions Other Than Paasmentioning

confidence: 97%

Prevention and management of infectious complications in prostate biopsy: A review

Shigemura

Fujisawa

2021

Int J of Urology

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“…Finally, a single RCT showed no evidence of benefit for perineal skin disinfection [45]. Hence, the rectal preparation with povidone-iodine is currently the only technical intervention to decrease infectious complications following prostate biopsy.…”

Section: Rectal Preparationmentioning

confidence: 99%

Update on Strategies to Reduce Infectious Complications After Prostate Biopsy

Pilatz

Veeratterapillay

Köves³

et al. 2019

European Urology Focus

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“…Meta-analysis of six trials including 1,373 men showed that use of a rectal povidone-iodine preparation before biopsy in addition to antimicrobial prophylaxis resulted in a lower rate of infectious complications [RR (95% CIs) = 0.58 (0.43 to 0.76)] [392][393][394][395][396][397]. Single RCTs showed no evidence of benefit for perineal skin disinfection [398] but reported an advantage for rectal povidone-iodine preparation before biopsy compared to after biopsy [453].…”

Section: Rectal Preparationmentioning

confidence: 99%

Experimental modeling of bacterial prostatitis. Review

Kogan¹,

Naboka²,

Ismailov³

et al. 2019

ECU

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Different classification systems of UTI exist. Most widely used are those developed by the Centers for Disease Control and Prevention (CDC) [6], Infectious Diseases Society of America (IDSA) [7], European Society of Clinical Microbiology and Infectious Diseases (ESCMID) [8] as well as the U.S. Food and Drug Administration (FDA) [9, 10]. Current UTI guidelines frequently use the concept of uncomplicated and complicated UTI with a number of modifications (Figure 1). In 2011 the EAU/EAU Section of Infections in Urology proposed the ORENUC classification system based on the clinical presentation of the UTI, categorisation of risk factors and availability of appropriate antimicrobial therapy [11]. Figure 1-Concept of uncomplicated and complicated UTI The following classification of UTIs is adopted in the EAU Urological Infections Guidelines: Classification of UTI Uncomplicated UTIs Acute, sporadic or recurrent lower (uncomplicated cystitis) and/or upper (uncomplicated pyelonephritis) UTI, limited to non-pregnant, premenopausal women with no known anatomical and functional abnormalities within the urinary tract or comorbidities. Complicated UTIs All UTIs which are not defined as uncomplicated. Meaning in a narrower sense UTIs in a patient with an increased chance of a complicated course: i.e. all men, pregnant women, patients with anatomical or functional abnormalities of the urinary tract, indwelling urinary catheters, renal diseases, and/or with other concomitant immunocompromising diseases for example, diabetes. Recurrent UTIs Recurrences of uncomplicated and/or complicated UTIs, with a frequency of at least three UTIs/year or two UTIs in the last six months. Catheter-associated UTIs Catheter-associated urinary tract infection (CA-UTI) refers to UTIs occurring in a person whose urinary tract is currently catheterised or has been catheterised within the past 48 hours. Urosepsis A systemic, deleterious host response to infection originating from the urinary tract and/or male genital organs. Urosepsis is accompanied by signs of systemic inflammation, presence of symptoms of organ dysfunction and persistent hypotension associated with tissue anoxia. 3.2 Antimicrobial stewardship Antimicrobial stewardship programmes aim to optimise the outcome of prevention and treatment of infection whilst curbing overuse and misuse of antimicrobial agents [12-16]. Measures of success include regulating antimicrobial prescribing, and reduction in both the rate of healthcare associated infections such as Clostridium difficile and the emergence of resistant organisms [16]. In urology, antimicrobial stewardship programmes should include a series of measures to ensure rational, evidence based use of antimicrobials in the prevention and treatment of infections of the urinary tract and male accessory glands, as well as non-antimicrobial strategies. Programmes require a stewardship team approach comprising urologists, infectious diseases Cystitis Pyelonephritis Recurrent UTI Catheter-associated UTI Urosepsis Complicated UTI Uncomplicated UTI U...

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Mp48-11 Prospective Randomized Controlled Study to Assess the Effect of Perineal Region Cleansing With Povidone Iodine Before Transrectal Needle Biopsy of the Prostate on Infectious Complications

Cited by 3 publications

References 0 publications

Prevention and management of infectious complications in prostate biopsy: A review

Prevention and management of infectious complications in prostate biopsy: A review

Update on Strategies to Reduce Infectious Complications After Prostate Biopsy

Experimental modeling of bacterial prostatitis. Review

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