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SUO 2017

SUO 2017: Previous Prostate Biopsy-related Complications And The Type Of Complication Are Associated With Lower Patient Compliance With Re-Biopsy Scheme

Washington, DC (UroToday.com) Introduction: Prostate biopsy-related complications such as hematuria, urinary tract infection (UTI) and acute urinary retention (AUR) have important health-related and financial consequences. Additionally, they may affect decrease patient compliance with re-biopsy. This led the authors to attempt to evaluate whether previous prostate biopsy-related complications and the type of complication were associated with repeat prostate biopsy compliance in a clinical trial with systematic biopsies.

Methods: This was a retrospective analysis of 5,087 men 50-75 years-old who underwent a 2-year study-mandated prostate biopsy and were recommended to undergo the 4-year study-mandate prostate re-biopsy in the Reduction by Dutasteride of prostate cancer (PC) Events (REDUCE) study. The analyzed biopsy-related complications at the 2-year prostate biopsy were: hematuria, UTI,
AUR and hematospermia, or any of the former. The association of 2-year biopsy complication with 4-year re-biopsy compliance was evaluated with chi-squared and logistic regression controlling for clinical variables.

Results: A total of 265 (5.2%) men had a 2-year prostate biopsy-related complication, including 182 (3.6%) who had hematuria, 39 (0.8%) UTI, 26 (0.5%) AUR, and 104 (2.0%) hematospermia. Biopsy-related complications were associated with lower PSA levels and placebo arm (both P<0.05). A total of 493 (9.7%) men were noncompliant with the 4-year biopsy. In univariable analysis, any previous complication (OR=1.50, P=0.029), UTI (OR=2.43, P=0.026), AUR (OR=4.19, P=0.001), and hematospermia (OR=1.72, P=0.050) were associated with higher risk of re-biopsy non-compliance. Hematuria was not associated with repeat biopsy compliance (OR=1.16, P=0.55). Results were unchanged in multivariable analysis (any complication: OR=1.53, P=0.024; UTI: OR=2.56, P=0.021; AUR: OR=4.09, P=0.001; hematospermia: OR=1.80, P=0.035; hematuria: OR=1.18, P=0.51).

Conclusion: The authors concluded that among men undergoing repeat prostate biopsy, a previous prostate biopsy-related complication and the type of complication were associated with lower compliance with re-biopsy scheme. The authors therefore conclude that these specific patients should receive counseling regarding the importance and safety of prostate re-biopsy to prevent a high rate of noncompliance.

Presented by: Daniel Moreira, University of Illinois at Chicago, USA

Written by: Hanan Goldberg, MD, Urologic Oncology Fellow (SUO), University of Toronto, Princess Margaret Cancer Centre, @GoldbergHanan, at the 18th Annual Meeting of the Society of Urologic Oncology, November 29-December 1, 2017 – Washington, DC