TY  - JOUR
A1  - Wenzel, Mike
A1  - Theißen, Lena
A1  - Preißer, Felix Martin
A1  - Lauer, Benedikt
A1  - Wittler, Clarissa
A1  - Humke, Clara Julia
A1  - Bodelle, Boris
A1  - Ilievski, Valentina
A1  - Kempf, Volkhard A. J.
A1  - Kluth, Luis
A1  - Chun, Felix
A1  - Mandel, Philipp
A1  - Becker, Andreas
T1  - Complication rates after trus guided transrectal systematic and mri-targeted prostate biopsies in a high-risk region for antibiotic resistances
T2  - Frontiers in Surgery
N2  - Introduction: There is still an ongoing debate whether a transrectal ultrasound (TRUS) approach for prostate biopsies is associated with higher (infectious) complications rates compared to transperineal biopsies. This is especially of great interests in settings with elevated frequencies of multidrug resistant organisms (MDRO).
Materials and Methods: Between 01/2018 and 05/2019 230 patients underwent a TRUS-guided prostate biopsy at the department of Urology at University Hospital Frankfurt. Patients were followed up within the clinical routine that was not conducted earlier than 6 weeks after the biopsy. Among 230 biopsies, 180 patients took part in the follow-up. No patients were excluded. Patients were analyzed retrospectively regarding complications, infections and underlying infectious agents or needed interventions.
Results: Of all patients with follow up, 84 patients underwent a systematic biopsy (SB) and 96 a targeted biopsy (TB) after MRI of the prostate with additional SB. 74.8% of the patients were biopsy-naïve. The most frequent objective complications (classified by Clavien-Dindo) lasting longer than one day after biopsy were hematuria (17.9%, n = 32), hematospermia (13.9%, n = 25), rectal bleeding (2.8%, n = 5), and pain (2.2%, n = 4). Besides a known high MDRO prevalence in the Rhine-Main region, only one patient (0.6%) developed fever after biopsy. One patient each (0.6%) consulted a physician due to urinary retention, rectal bleeding or gross hematuria. There were no significant differences in complications seen between SB and SB + TB patients. The rate of patients who consulted a physician was significantly higher for patients with one or more prior biopsies compared to biopsy-naïve patients.
Conclusion: Complications after transrectal prostate biopsies are rare and often self-limiting. Infections were seen in <1% of all patients, regardless of an elevated local prevalence of MDROs. Severe complications (Clavien-Dindo ≥ IIIa) were only seen in 3 (1.7%) of the patients. Repeated biopsy is associated with higher complication rates in general.
KW  - transrectal prostate biopsy
KW  - complications
KW  - systematic biopsy
KW  - targeted biopsy
KW  - infection
KW  - biopsy naïve
KW  - repeat biopsy
Y1  - 2020
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/52949
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-529497
SN  - 2296-875X
N1  - Copyright © 2020 Wenzel, Theissen, Preisser, Lauer, Wittler, Humke, Bodelle, Ilievski, Kempf, Kluth, Chun, Mandel and Becker. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
VL  - 7
IS  - Art. 7
SP  - 1
EP  - 7
PB  - Frontiers Media
CY  - Lausanne
ER  -