Prostate International (Sep 2022)

Non-infectious complications following transrectal prostate needle biopsy – Outcomes from over 8000 procedures

  • Adrian Sosenko,
  • Russell G. Owens,
  • Ae Lim Yang,
  • Ahmad Alzubaidi,
  • Thomas Guzzo,
  • Edouard Trabulsi,
  • John Danella,
  • Gregory Diorio,
  • Adam Reese,
  • Jeffrey Tomaszewski,
  • Serge Ginzburg,
  • Marc Smaldone,
  • Claudette Fonshell,
  • Kaynaat Syed,
  • Bruce Jacobs,
  • Eric A. Singer,
  • Jay D. Raman

Journal volume & issue
Vol. 10, no. 3
pp. 158 – 161

Abstract

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Background: Prostate needle biopsy (PNB) remains the referent standard for diagnosing prostate cancer. Contemporary data highlight an increase in PNB-related infections particularly when performed transrectally. Non-infectious complications, however, may similarly contribute to biopsy-related morbidity. We review the incidence and predictors of non-infectious complications following transrectal PNB in a large statewide quality registry. Methods: Transrectal ultrasound-guided prostate needle biopsies performed between 2015 and 2018 were retrospectively reviewed. The incidence and distribution of non-infectious complications were annotated. Clinical, demographic, and biopsy variables of interest were evaluated by logistic regression for potential association with specific types of non-infectious complications. Results: Of 8,102 biopsies, 277 (3.4%) biopsies had reported post-procedure complications including 199 (2.5%) non-infectious and 78 (0.9%) infectious. Among the non-infectious complications, the most common events included urinary or rectal bleeding (74; 0.9%), urinary retention (70, 0.9%), vasovagal syncope (13, 0.2%), and severe post-operative pain (10, 0.1%). Approximately 56% of these non-infectious complications required an Emergency Department visit (111/199) and 27% (54/199) hospital admission for monitoring. Increasing transrectal ultrasound prostate volume was associated with post-procedure urinary retention (Odds ratio (OR) 1.07, 1.02–1.11, p = 0.002). No specific variables noted association with post-biopsy bleeding. Conclusion: Non-infectious complications occurred 2.5 times more often than infectious complications following transrectal ultrasound prostate needle biopsies. Larger prostate size was associated with a greater risk of post-procedure urinary retention. These data originating from experience from over 100 urologists across different health systems provide an important framework in counseling patients regarding expectations following transrectal prostate biopsy.

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