The Association of Previous Prostate Biopsy-Related Complications and the Type of Complication with Patient Compliance with Re-Biopsy Scheme

Prostate biopsy complications have important consequences that may affect patient compliance with re-biopsy schemes; however, this has not been studied in earnest. Thus, we evaluated whether previous prostate biopsy-related complications and the type of complication were associated with repeat prostate biopsy compliance in a clinical trial with study-mandated systematic biopsies.

Retrospective analysis of 4,939 men ages 50-75 who underwent a 2-year prostate biopsy and were recommended to undergo the 4-year prostate re-biopsy in the Reduction by Dutasteride of prostate cancer Events (REDUCE) study. The analyzed biopsy complications were: hematuria, urinary tract infection (UTI), acute urinary retention (AUR) and hematospermia.

A total of 260 (5.3%) men had a 2-year prostate biopsy-related complication, including 180 (3.6%) hematuria, 36 (0.7%) UTI, 26 (0.5%) AUR, and 102 (2.1%) hematospermia. A total of 474 (9.6%) men were noncompliant with the 4-year re-biopsy. In univariable analysis, any previous complication (OR=1.56, 95%CI=1.08-2.24, P=0.018), UTI (OR=2.72, 95%CI=1.23-6.00, P=0.013), AUR (OR=4.24, 95%CI=1.83-9.81, P=0.016) and hematospermia (OR=1.78, CI=1.03-3.06, P=0.037) were associated with re-biopsy noncompliance. Hematuria was not associated with re-biopsy noncompliance (OR=1.19, CI=0.74-1.91, P=0.483). Results were unchanged in multivariable analysis (any complication: OR=1.65, 95%CI=1.08-2.26, P=0.018; UTI: OR=2.62, 95%CI=1.07-3.21, P=0.029; AUR: OR=4.51, 95%CI=1.93-10.54, P=0.001; hematospermia: OR=1.85, 95%CI=1.07-3.21, P=0.029; hematuria: OR=1.19, 95%CI=0.74-1.93, P=0.472).

In men undergoing repeat prostate biopsy, a previous biopsy-related complication and the type of complication were associated with lower compliance with re-biopsy schemes. Patients experiencing biopsy-related complications are ideal candidates to receive interventions regarding the importance of prostate re-biopsy to prevent noncompliance.

The Journal of urology. 2018 Jun 12 [Epub ahead of print]

Logan S Schwarzman, Michael R Abern, Daniel F Garvey, Gerald L Andriole, Stephen J Freedland, Daniel M Moreira

Department of Urology, University of Illinois at Chicago, Chicago, IL., Division of Urologic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, MO., Division of Urology, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, and the Section of Urology Durham VA Medical Center, Durham, NC., Department of Urology, University of Illinois at Chicago, Chicago, IL. Electronic address: .