Prevention of Pain and Infective Complications after Transrectal Prostate Biopsy: A Prospective Study

Akay, Ali; Akay, Hatice; Aflay, Uğur; Şahın, Hayrettin; Bircan, K.

doi:10.1007/s11255-005-8440-3

Cited by 10 publications

(4 citation statements)

References 11 publications

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“…Our study did not explore on why patients were given antibiotics uphazardly but probably clinicians’ thoughts are to decrease of post intervention bacteriuria, or decrease of symptomatic UTIs or other infectious complications’ While the aim of preventing symptomatic UTIs and other serious infectious complications seems evident, the need to prevent asymptomatic bacteriuria remains questionable. Asymptomatic bacteriuria is often of no clinical importance and resolves spontaneously in many cases as the findings of other studies elsewhere [ 1 , 3 – 11 , 13 , 18 ]. This being a retrospective study, we could not asses the outcomes of those patients post urological intervention therefore we could not find high evidence supporting the use of antibiotic prophylaxis in urologic interventions to prevent complications such as UTI including in those who had TURP done as it was found out in other studies that no enough evidence supports the systematic use of antibiotic prophylaxis to prevent UTIs in the rest of the procedures.…”

Section: Discussionmentioning

confidence: 61%

Antibiotic use in urological surgeries: a six years review at Muhimbili National Hospital, Dar es salaam-Tanzania

Nyongole¹,

Akoko²,

Mwanga³

et al. 2015

Pan Afr Med J

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IntroductionAntimicrobial prophylaxis for urologic procedures is a major issue, as potential advantages of antibiotic administration should be carefully weighed against potential side effects, microbial resistance, and health care costs. This study aimed to review a six years trend of antibiotic use in urological surgeries at Muhimbili National Hospital (MNH) being an experience in a typical third world environment.MethodsThis was a six years hospital based descriptive, retrospective study conducted of which all case notes of urological patients operated on in between January 2007 to December, 2012 were reviewed by using a structured data collecting tool. The data were analyzed using SPSS software.ResultsMale patients were the majority at 62% (450). The age range was 0 - 90 years, with a mean of 30 ± 22.09. Among the urological surgeries done at MNH 86.5% (628) received prophylactic antibiotics regardless of the type surgery done. Majority 63.7% (463) received antibiotics during induction. Ceftriaxone was the commonly given antibiotic regardless of the type of urological surgery done. Most of patients (86.4%) were given antibiotics for five days regardless whether it was for prophylactic or treatment intention.ConclusionAntibiotic use is still a challenge at our hospital with over use of prophylactic antibiotics without obvious indications. Prolonged use of prophylactic antibiotics beyond five days was the main finding. Ceftriaxone was the most given antibiotic regardless of the urological surgery done and its level of contamination. Antibiotic stewardship needs to be addressed urgently to avoid serious drug resistances leaving alone the cost implication.

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Section: Discussionmentioning

confidence: 61%

Antibiotic use in urological surgeries: a six years review at Muhimbili National Hospital, Dar es salaam-Tanzania

Nyongole¹,

Akoko²,

Mwanga³

et al. 2015

Pan Afr Med J

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“…As previous cleansing with povidone-iodine has been reported to increase distress and irritation, this study demonstrates that the application of suppository types is effective in significantly lessening patient discomfort. [15]…”

Section: Discussionmentioning

confidence: 99%

A prospective randomized trial of povidone-iodine suppository before transrectal ultrasonography-guided prostate biopsy

Ryu¹,

Song²,

Lee³

et al. 2019

Medicine

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Objectives: To investigate a way to reduce infectious complication after transrectal ultrasonography-guided prostate biopsy (TRUS-Bx), we planned a randomized trial to determine whether the use of the povidone-iodine suppository is effective in preventing infectious complications. Methods: This study prospectively assessed 250 patients who underwent TRUS-Bx during December 2014 and May 2016. Clinical questionnaire responses and safety were evaluated. Povidone-iodine suppository after glycerin enema was performed 1 to 2 hours before TRUS-Bx. Both groups received the prophylactic antibiotics (ceftriaxone 2.0 g) 30 to 60 minutes before TRUS-Bx. No antibiotics were prescribed after TRUS-Bx. Results: The 120 were assigned in the treatment group using povidone-iodine suppository and 130 were assigned in the control group. There was no significant difference of clinicopathologic features including age, prostate-specific antigen and cancer detection rate in both groups ( P > .05). No infectious and non-infectious complications were reported in both groups. Povidone-iodine suppository-related side effects were not reported. No significant differences in international prostate symptom score, sexual health inventory for men score, and European Organization for Research and Treatment of Cancer Quality of Life questionnaire scores were found between the 2 groups ( P > .05). No changes in each questionnaire scores between before and after TRUS-Bx were observed. Conclusions: Despite satisfying the predefined sample size, we could not prove the hypothesis that the use of povidone-iodine suppositories after TRUS-Bx would reduce infectious complications. A large-scale, multicenter, prospective study is needed to fully evaluate the clinical efficacy and safety of povidone-iodine suppository prior to TRUS-Bx.

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“…Brown et al [30] reported that rectal preparation with povidone-iodine is a safe and reliable method to prevent infections. Akay et al [31] reported lavage with povidone-iodine decreased the postbiopsy infection rates. Huang et al [32] combined povidone-iodine with a phosphate-based enema and found that postbiopsy infection rates were decreased significantly.…”

Section: Discussionmentioning

confidence: 99%

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

Koç¹,

Ün²,

Filiz³

et al. 2010

Urol Int

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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.

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Prevention of Pain and Infective Complications after Transrectal Prostate Biopsy: A Prospective Study

Abstract: Lavage with betadine prior to transrectal prostate biopsy is adequate in the prevention of infective complications; however, because lidocaine gel is not effective against pain, alternative methods for pain management need to be developed.

Cited by 10 publications

References 11 publications

Antibiotic use in urological surgeries: a six years review at Muhimbili National Hospital, Dar es salaam-Tanzania

Antibiotic use in urological surgeries: a six years review at Muhimbili National Hospital, Dar es salaam-Tanzania

A prospective randomized trial of povidone-iodine suppository before transrectal ultrasonography-guided prostate biopsy

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

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