San Diego, CA USA (UroToday.com) Transrectal ultrasound-guided prostate biopsy (TRUS-Bx) is the standard of care for prostate cancer diagnosis. However, infectious complications post-TRUS-Bx has increased in recent years. In effort to discern the affect of these complications on RP outcomes, Dr. Daniel Olvera-Posada conducted a population-based cohort analysis comparing surgical outcomes of patients who did or did not suffer from TRUS-Bx complications.
From April 2002 to March 2013, 27,637 patients undergoing RP in Ontario were identified, 711 of which experienced hospitalization due to urinary tract infection (UTI) or sepsis within 30-days post TRUS-Bx complications. The composite primary outcome was identified as surgical complication, post-operative treatment of urinary fistula, intestinal diversion, upper urinary tract obstruction or ureteral injury; the secondary outcome consisted of oncological, functional and hospital related events.
From these guidelines, patients with an infectious post-TRUS-Bx experienced a higher rate of composite primary outcome (OR 1.89, 95% CI 1.10-3.25, p=0.019), 30 day hospital readmission (OR 1.88, 95% CI 1.37-2.58, p<0.001), and blood transfusion (OR 1.74, 95% CI 1.44-2.09, p<0.0001), contributing to a lengthened hospital stay (p<0.0001). No differences, however, were found in the proportion of patients requiring adjuvant radiation, hormonal treatment, invasive therapies for incontinence or ED, or 30-day mortality rate.
Overall, this population-based study demonstrated that TRUS-Bx related infectious event is significantly associated with a higher risk of surgical complications, blood transfusion, readmission rate and prolonged hospital stays. While functional outcomes and need for other therapy appear similar post-RP, infectious complications post-TRUS-Bx may still negatively impact surgical outcomes.
With regards to clinical practice, researchers of this study suggested an increase in wait time post-TRUS-Bx infectious complications. Since oncological outcomes are not affected, an increase of wait time to 6 to 9 months may compel the surgeon to wait longer.
Presented By: Daniel Olvera-Posada, MD
Written By: Linda Huynh; Biomedical Research Student, Department of Urology, University of California, Irvine at the 2016 AUA Annual Meeting - May 6 - 10, 2016 – San Diego, California, USA