Urology Research & Practice
Original Article

Complications of transrectal ultrasound-guided 12-core prostate biopsy: a single center experience with 2049 patients

1.

Clinic of Urology, Develi Hatice-Muammer Kocatürk State Hospital, Kayseri, Turkey

2.

Department of Urology, Faculty of Medicine, Mersin University, Mersin, Turkey

3.

Department of Urology, Faculty of Medicine, Mersin University, Mersin, Turkey

Urol Res Pract 2013; 39: 6-11
DOI: 10.5152/tud.2013.002
Read: 1934 Downloads: 1087 Published: 25 July 2019

Abstract

Objective: Currently, the performance of a systematic prostate biopsy under transrectal ultrasound (TRUS) guidance is the standard procedure in the diagnosis of prostate cancer. Although TRUS-guided prostate biopsy is considered to be a safe method, it is an invasive procedure that is not free from complications. We prospectively evaluated the morbidity and complication rates for a TRUS-guided 12-core prostate biopsy.

 

Material and methods: The study included 2049 patients undergoing transrectal ultrasound-guided 12-core prostate biopsy. The indications for the prostate biopsy were abnormal digital rectal examination findings and/or an elevated serum total prostate specific antigen (PSA) level (greater than 4 ng/mL). The participants received prophylactic oral ciprofloxacin (500 mg) the night before and the morning of the biopsy, followed by 500 mg orally twice daily for 2 days; patients also received oral alpha blockers for 30 days starting the day before the procedure. A Fleets enema was self-administered the night before the procedure. The complications were assessed both 10 days and 1 month after the biopsy.

 

Results: The mean age, serum total PSA level and prostate volume were 65.4±9.6 years, 18.6±22.4 ng/mL and 51.3±22.4 cc, respectively. From these 2,042 biopsies, 596 cases (29.1%) were diagnosed as prostate cancer. Minor complications, such as hematuria (66.3%), hematospermia (38.8%), rectal bleeding (28.4%), mild to moderate vasovagal episodes (7.7%), and genitourinary tract infection (6.1%) were noted frequently. Major complications were rare and included urosepsis (0.5%), rectal bleeding that required intervention (0.3%), acute urinary retention (0.3%), hematuria that required transfusion (0.05%), Fournier’s gangrene (0.05%), and myocardial infarction (0.05%).

 

Conclusion: TRUS-guided prostate biopsy is safe for diagnosing prostate cancer with few major but frequent minor complications. However, patients should be informed and followed-up with regarding possible complications.

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