This was a prospective randomized controlled study that enrolled a total of 802 consecutive patients undergoing prostate biopsies with a 1: 1 randomization ratio for two distinct groups. Group A included rectal cleansing and disinfection of the needle tip vs. Group B, which were controls with standard prebiopsy preparation. All patients obtained a urine culture 48 hours following the prostate biopsy and completed a telephone interview seven days after undergoing the procedure. The primary endpoint of this study was the rate of infectious complications, defined as 1 or more of the following events: Urinary tract infection (UTI), and fever or sepsis (standardized definition). The authors also attempted to evaluate the factors associated with infectious complications.
Infectious complications were observed in 33 (4%) patients, of whom, 8 (1%) had a fever, 14 (1.7%) had UTI, and 11 (1.4%) endured sepsis. The rate of infectious complications was lower in group A (2.8% versus 5.3%, OR=0.52, 95% CI 0.25-1.08, p= 0.07). The overall rate of positive urine culture was also lower in group A: 17 (4.9%) vs. 28 (9.4%), p=0.026. On multivariable analysis, prior use of urinary indwelling catheters was associated with asymptomatic bacteriuria (p=0.026). Additionally, previous use of antibiotics in the last three months before the prostate biopsy was marginally correlated to a higher risk of infectious complications.
In conclusion, rectal cleansing with povidone-iodine plus disinfection of the biopsy needle tip at transrectal ultrasound guided prostate biopsy was marginally associated with the reduction of infectious complications following a prostate biopsy.
Presented by: Felipe Costa, MD, Departamento de Anatomia Patológica, A.C. Camargo Cancer Center, São Paulo, Brazil
Written by: Hanan Goldberg, MD, Urologic Oncology Fellow (SUO), University of Toronto, Princess Margaret Cancer Centre @GoldbergHanan at the American Urological Association's 2019 Annual Meeting (AUA 2019), May 3 – 6, 2019 in Chicago, Illinois