The Problem of Infection after Prostatic Biopsy: The Case for the Transperineal Approach

Abstract

The incidence of infection after needle biopsy of the prostate by different techniques was compared in 45 patients. Aerobic and anaerobic culture was made of the biopsy needle, prostate, urine and blood. In addition, endotoxin assays were determined by a new chromogenic method using Limulus lysate. All of the patients undergoing transrectal biopsy were found to have a bacteraemia; 27% were symptomatic and 87% had a post-operative urinary tract infection. A double-blind controlled trial using cefamandole with the premedication showed a significant reduction in the incidence of bacteraemia to 53% and the prevention of a urinary tract infection. Following transperineal biopsy, although the incidence of bacteraemia was 40% and urinary tract infection 27%, none of these patients was symptomatic and the organisms causing the bacteraemia were predominantly skin contaminants. The endotoxin assays showed differences between the groups with higher endotoxin values in the unprotected transrectal group.

Epidural abscess with associated spondylodiscitis following prostatic biopsy

“…Occurrence of infective complications following TRUBP is not surprising given that 100% of patients develop a transient bacteraemia following the intervention. 4 The risk of discitis is increased as a result of the direct vascular connection between venous drainage of both the prostate and lumbar vertebrae. 3.9%.…”

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

“…2,6 Although many studies have reported the incidence of complications, they were not specifically designed to evaluate the true complication rate and its implications. [8][9][10][11][12] It is essential to have a clear understanding of the true morbidity of this procedure, and this would enable appropriate patient counseling.…”

Application of Prostate Ultrasound for Prostate Biopsy

“…In the pre-prophylaxis era, Thompson demonstrated a bacteremia rate of 100 % with a bacteruria rate of 87 %. This decreased to 44 % and 16 %, respectively, with enema alone [ 83 ]. Crawford et al administered 48 h of carbenicillin and noted bacteruria to decrease from 36 % to 9 % versus the control group [ 6 ].…”