Risks on rise with transrectal ultrasound-guided biopsy

New research from Sweden shows that risks associated with transrectal ultrasound-guided biopsy are increasing, with men vulnerable to urinary tract infections and subsequent hospitalization, according to a study published online on 20 August in the Journal of Urology.

The study from Umeå University in Östersund found that 6% of men filled a prescription for antibiotics for a urinary tract infection within 30 days after a prostate biopsy, with a two-fold increase in hospital admissions during the five-year study period.

Of the men who filled the prescription for urinary tract antibiotics within 30 days of biopsy, 54% of them needed the prescription in the first week after biopsy, while 1% were hospitalized with a urinary tract infection.

Swedish researchers, led by Dr. Karl-Johan Lundström, reviewed records of more than 51,000 men registered in the Swedish Prostate Cancer database who underwent transrectal ultrasound-guided prostate biopsy between 2006 and 2011. They also compiled data from the National Prostate Cancer Register (NPCR) of Sweden, which details more than 96% of all newly diagnosed prostate cancers in the country.

During those years, the number of men obtaining an antibiotic prescription after biopsy decreased, while the number who were hospitalized increased. There was no significant increase in 90-day mortality observed.

The strongest risk factors for an antibiotic prescription were multiple comorbidities, particularly diabetes, and prior infection. Overall, approximately 2% of men had a urinary tract infection during the six months before biopsy.

Lundström and colleagues noted that while the rate of hospital admission doubled over five years, the risk of dying of an infection after prostate biopsy was very low.

They added that the increasing risk of hospitalization is concerning, and highlights the importance of carefully evaluating clinical indications for biopsy, especially in men at increased risk of infection.

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