Sepsis rates after ultrasound-guided prostate biopsy using a bowel preparation protocol in a community hospital

Abstract

Objectives: The purpose of this study was to determine whether the addition of disposable enemas and a 24-hour diet of clear fluids to the bowel preparation protocol before transrectal ultrasound-guided prostate biopsy decreases the rate of postbiopsy sepsis.

Methods: Sepsis rates of patients who underwent transrectal ultrasound-guided prostate biopsies at a community hospital were analyzed before and after a new bowel preparation protocol was introduced in our department. All patients received the antibiotic ciprofloxacin both before and after the biopsy. The first group (190 patients) had a preparation protocol that only asked the patients to stop eating by midnight (clear fluids only) on the day before the biopsy. The second group involved 217 patients and followed a bowel-cleansing biopsy preparation protocol. This protocol included the use of 2 disposable enemas and a diet of clear fluids for 24 hours preceding the biopsy. A systematic chart review was then performed to determine which patients had required treatment for postbiopsy sepsis.

Results: Sepsis occurred in 4 patients (2.11%) in group 1 and 1 patient (0.46%) in group 2. After performing a 2-sided Fisher exact test, it was found that there was no significant difference between the groups at a 95% confidence level (P = .189).

Conclusions: The 24-hour clear-fluid diet and the use of disposable enemas combined with a regimen of ciprofloxacin decreased the rate of postbiopsy sepsis in patients who underwent transrectal ultrasound-guided prostate biopsy, but the results were not significantly different.