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. 2022 Mar;10(1):34-37.
doi: 10.1016/j.prnil.2021.11.001. Epub 2021 Dec 7.

Is antibiotic prophylaxis still mandatory for transperineal prostate biopsy? Results of a comparative study

Giacomo M Pirola  1 , Marilena Gubbiotti  1 , Emanuele Rubilotta  2 , Daniele Castellani  3 , Nicolò Trabacchin  2 , Alessandro Tafuri  2 , Alessandro Princiotta  2 , Eugenio Martorana  4 , Filippo Annino  1 , Alessandro Antonelli  2
Affiliations

Is antibiotic prophylaxis still mandatory for transperineal prostate biopsy? Results of a comparative study

Giacomo M Pirola et al. Prostate Int. 2022 Mar.

Abstract

Introduction and objectives: This study aimed to assess the incidence of urinary tract infections (UTIs) after transperineal prostate biopsy (TP-PB) comparing patients who underwent antibiotic prophylaxis (AP) with patients who had no prophylaxis.

Materials and methods: This prospective, double-center trial was conducted between August and December 2020. Patient candidates to PB were included with 1:1 allocation to case (Group A-no AP) and control group (Group B-standard AP). All TP-PBs were performed in an outpatient setting under local anesthesia. Data collected 2 weeks after the procedure included incidence of UTIs or bacteriuria, evaluated with a urine culture (UC), main symptoms, and complications related to TP-PBs.

Results: A total of 200 patients were included (100 patients in each group). The mean age was 66.2 ± 7.7 in Group A and 67.4 ± 8 years in Group B (P = 0.134). Mean prostate volume was 65.5 ± 26.7 vs. 51 ± 24.6 cc (P < 0.001), number of biopsy cores was 17.8 ± 2.4 vs. 14.9 ± 0.8 (P < 0.001), and PSA value was 15.9 ± 28.1 vs. 13.3 ± 22.3 ng/ml (P = 0.017). Overall PCa detection rate was 55% vs. 59% (P = 0.567). Postoperative UTI occurred in one patient in Group A vs. zero in Group B. Asymptomatic bacteriuria was present in 3 vs. 5 patients (P = 0.470) and was not treated with antibiotics. Postoperative hematuria was observed in 13 patients vs. 29 (P < 0.05), and acute urinary retention was observed in one patient in each group.

Conclusions: The incidence of bacteriuria and UTIs in TP-PBs is not related to AP. Therefore, AP could be discontinued in TP-PB candidates without the risk of increasing UTI-related complications.

Keywords: Antibiotic prophylaxis; Prostate biopsy; Prostate cancer screening; Transperineal.

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Conflict of interest statement

All Authors certify that they have NO affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or nonfinancial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

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