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. 2022 Sep;10(3):158-161.
doi: 10.1016/j.prnil.2022.04.002. Epub 2022 Apr 23.

Non-infectious complications following transrectal prostate needle biopsy - Outcomes from over 8000 procedures

Adrian Sosenko  1 , Russell G Owens  2 , Ae Lim Yang  2 , Ahmad Alzubaidi  1 , Thomas Guzzo  3 , Edouard Trabulsi  4 , John Danella  5 , Gregory Diorio  6 , Adam Reese  7 , Jeffrey Tomaszewski  8 , Serge Ginzburg  9 , Marc Smaldone  10 , Claudette Fonshell  11 , Kaynaat Syed  11 , Bruce Jacobs  12 , Eric A Singer  13 , Jay D Raman  1
Affiliations

Non-infectious complications following transrectal prostate needle biopsy - Outcomes from over 8000 procedures

Adrian Sosenko et al. Prostate Int. 2022 Sep.

Abstract

Background: Prostate needle biopsy (PNB) remains the referent standard for diagnosing prostate cancer. Contemporary data highlight an increase in PNB-related infections particularly when performed transrectally. Non-infectious complications, however, may similarly contribute to biopsy-related morbidity. We review the incidence and predictors of non-infectious complications following transrectal PNB in a large statewide quality registry.

Methods: Transrectal ultrasound-guided prostate needle biopsies performed between 2015 and 2018 were retrospectively reviewed. The incidence and distribution of non-infectious complications were annotated. Clinical, demographic, and biopsy variables of interest were evaluated by logistic regression for potential association with specific types of non-infectious complications.

Results: Of 8,102 biopsies, 277 (3.4%) biopsies had reported post-procedure complications including 199 (2.5%) non-infectious and 78 (0.9%) infectious. Among the non-infectious complications, the most common events included urinary or rectal bleeding (74; 0.9%), urinary retention (70, 0.9%), vasovagal syncope (13, 0.2%), and severe post-operative pain (10, 0.1%). Approximately 56% of these non-infectious complications required an Emergency Department visit (111/199) and 27% (54/199) hospital admission for monitoring. Increasing transrectal ultrasound prostate volume was associated with post-procedure urinary retention (Odds ratio (OR) 1.07, 1.02-1.11, p = 0.002). No specific variables noted association with post-biopsy bleeding.

Conclusion: Non-infectious complications occurred 2.5 times more often than infectious complications following transrectal ultrasound prostate needle biopsies. Larger prostate size was associated with a greater risk of post-procedure urinary retention. These data originating from experience from over 100 urologists across different health systems provide an important framework in counseling patients regarding expectations following transrectal prostate biopsy.

Keywords: Biopsy; Complications; Non-infectious; Prostate.

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Conflict of interest statement

The authors have no conflict of interest pertaining to the material published in this manuscript.

Figures

Figure 1
Fig. 1
Distribution of complications in 8102 patients undergoing TRUS PNB. TRUS PNB, transrectal ultrasound-guided prostate needle biopsies.
See this image and copyright information in PMC

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