2060 INFECTIOUS COMPLICATIONS AND HOSPITAL ADMISSIONS AFTER PROSTATE BIOPSY IN A EUROPEAN RANDOMIZED TRIAL

Abstract

You have accessJournal of UrologyProstate Cancer: Detection and Screening IV1 Apr 20122060 INFECTIOUS COMPLICATIONS AND HOSPITAL ADMISSIONS AFTER PROSTATE BIOPSY IN A EUROPEAN RANDOMIZED TRIAL Stacy Loeb, Suzanne van den Heuvel, Xiaoye Zhu, Chris H. Bangma, Fritz H. Schroder, and Monique Roobol Stacy LoebStacy Loeb NY, NY More articles by this author , Suzanne van den HeuvelSuzanne van den Heuvel Rotterdam, Netherlands More articles by this author , Xiaoye ZhuXiaoye Zhu Rotterdam, Netherlands More articles by this author , Chris H. BangmaChris H. Bangma Rotterdam, Netherlands More articles by this author , Fritz H. SchroderFritz H. Schroder Rotterdam, Netherlands More articles by this author , and Monique RoobolMonique Roobol Rotterdam, Netherlands More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.2225AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The complications of prostate needle biopsy (PNB) are important when considering the benefits and harms of prostate cancer screening. Large studies from the US and Canada have recently reported a rise in hospitalizations for infectious complications after PNB. Our objective was to examine the risk of infectious complications and hospital admissions after PNB in a European screening trial. METHODS From 1993-2011, 10474 PNB were performed in the Rotterdam section of the European Randomized Study of Screening for Prostate Cancer. Prophylaxis consisted of trimethoprim-sulfamethoxazole until 2008, then Ciprofloxacin given 2 hours before and 4 hours after PNB; however, more extended prophylaxis was used in high-risk patients. Post-procedural febrile complications and hospital admissions were assessed by questionnaires 2 weeks after PNB. Logistic regression was used to identify risk factors for biopsy-related fever and hospital admission. RESULTS Fever and admission were reported on 392 of 9241 (4.2%) and 78 of 9198 (0.8%) questionnaires, respectively. Although most fevers were managed on an outpatient basis, infection was the leading indication for hospital admission (81.8%). Blood culture results were available for 56 men, of which 34 were positive, with E. coli as the predominant organism. On multivariable analysis, prostate enlargement and diabetes were significantly associated with an increased risk of fever after PNB; whereas, later year of biopsy was the only factor significantly associated with an increased risk of hospital admission. CONCLUSIONS In a European screening trial, <5% of PNB resulted in febrile complications. Significant risk factors included diabetes and prostatic enlargement. Although most fevers were managed on an outpatient basis, infection remained the leading cause of hospital admission after PNB. Consistent with prior international reports, the frequency of hospital admissions after PNB significantly increased over time. Nevertheless, the absolute frequency of hospital admissions related to PNB was low, and should not dissuade healthy men who would benefit from early prostate cancer diagnosis from undergoing biopsy when clinically indicated. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e831 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Stacy Loeb NY, NY More articles by this author Suzanne van den Heuvel Rotterdam, Netherlands More articles by this author Xiaoye Zhu Rotterdam, Netherlands More articles by this author Chris H. Bangma Rotterdam, Netherlands More articles by this author Fritz H. Schroder Rotterdam, Netherlands More articles by this author Monique Roobol Rotterdam, Netherlands More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...