Acute prostatitis after prostate biopsy under ciprofloxacin prophylaxis with or without ornidazole and pre-biopsy enema: analysis of 3.479 prostate biopsy cases.

To investigate the characteristics of cases of NIH category I acute prostatitis developed after transrectal prostate biopsy and clarifiy the risk factors and preventive factors.

We retrospectively reviewed the medical records of 3. 479 cases of transrectal ultrasound-guided needle biopsies performed with different prophylactic antibiotherapy regimens at two different institutions between January 2011 and February 2016. The patients of Group I have received ciprofloxacin (n=1.523, 500mg twice daily) and the patients of Group II have received ciprofloxacin plus ornidazole (n=1.956, 500mg twice daily) and cleansing enema combination as prophylactic antibiotherapy. The incidence, clinical features and other related microbiological and clinical data, were evaluated.

Mean age was 62.38 ± 7.30 (47-75), and the mean prostate volume was 43.17 ± 15.20 (21-100) mL. Of the 3.479 patients, 39 (1.1%) developed acute prostatitis after the prostate biopsy procedure. Of the 39 cases of acute prostatitis, 28/3.042 occurred after the fi rst biopsy and 11/437 occurred after repeat biopsy (p=0.038). In Group I, 22 of 1.523 (1.4%) patients developed acute prostatitis. In Group II, 17 of 1.959 (0.8%) patients developed acute prostatitis. There was no statistical difference between the two groups according to acute prostatitis rates (X2=2.56, P=0.11). Further, hypertension or DM were not related to the development of acute prostatitis (P=0.76, X2=0.096 and P=0.83, X2=0.046, respectively).

Repeat biopsy seems to increase the risk of acute prostatitis, while the use of antibiotics effective for anaerobic pathogens seems not to be essential yet.

International braz j urol : official journal of the Brazilian Society of Urology. 0000 Jan [Epub]

Muhsin Balaban, Orkunt Ozkaptan, Cuneyd Sevinc, Mustafa Yucel Boz, Rahim Horuz, Alper Kafkasli, Onder Canguven

Department of Urology, Biruni University School of Medicine, Istanbul, Turkey., Department of Urology, Kartal Training and Research Hospital, Istanbul, Turkey., Department of Urology, Istinye University School of Medicine, Istanbul, Turkey., Department of Urology, Medipol University School of Medicine, Istanbul, Turkey., Department of Urology, Hamad Medical Corporation, Doha, Qatar; Weill Cornell Medicine, NY, USA.