1078 RISK FACTORS FOR COMPLICATIONS AFTER PROSTATE BIOPSY AT THE VA

Abstract

You have accessJournal of UrologyInfections/Inflammation of the Genitourinary Tract: Prostate & Genitalia1 Apr 20121078 RISK FACTORS FOR COMPLICATIONS AFTER PROSTATE BIOPSY AT THE VA Aaron Lay, Joshua Kaplan, Stephen Williams, Steven Chang, Mike Siroky, and Ralph Orlando Aaron LayAaron Lay Boston, MA More articles by this author , Joshua KaplanJoshua Kaplan Boston, MA More articles by this author , Stephen WilliamsStephen Williams Boston, MA More articles by this author , Steven ChangSteven Chang Boston, MA More articles by this author , Mike SirokyMike Siroky Boston, MA More articles by this author , and Ralph OrlandoRalph Orlando Boston, MA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.1185AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Transrectal ultrasound (TRUS)-guided prostate biopsy is a standard method for diagnosing prostate cancer and is frequently performed. Morbidity associated with this procedure ranges from minor to life-threatening. Despite universal use of TRUS-biopsy among urologists, little is known about predisposing factors for these complications. We sought to identify the rate of complications after TRUS biopsy in a contemporary series of patients in order to identify risk factors and reduce morbidity. METHODS We retrospectively evaluated 1357 consecutive prostate biopsies performed at the VA Boston HealthCare System from 2006 to 2010. The electronic medical records were reviewed for any post-biopsy complication in the 30 days following biopsy. History of diabetes, recent hospitalization, previous biopsy history, previous urinary tract infection, antibiotic prophylaxis, anticoagulation use, prostate size (categorized as <20g, 20-40g, 40-60g, 60-80g, 80-100g, and >100g), number of cores sampled, and pathology results were recorded. We performed univariate and multivariate logistic regression analyses. RESULTS The overall complication rates were categorized as infection (2.65%), sepsis (1.84%), urinary retention (1.11%), vasovagal reaction (0.96%), bleeding (0.81%), and other (1.4%), which included culture-negative dysuria. In univariate analyses, prostate size was significantly associated with increased risk for urinary retention (OR 1.82, p=0.001) and any complication (OR 1.29, p=0.001). This association remained even when urinary retention was excluded as a complication (OR 1.21, p=0.020). In multivariate analyses, size (OR 1.3, p<0.001) and prior hospitalization within one year (OR 2.0, p=0.009) were significant risks for any complication. Previous history of urinary tract infection was associated with decreased risk for any complication (OR 0.24, p=0.007). CONCLUSIONS Patients with large glands and hospitalization within 1 year prior to biopsy are at increased risk of biopsy complications. For every 20g increase in size, there is a 30% increase in odds of developing any complication after biopsy. Patients with history of urinary tract infection had a lower risk for complication, suggesting that being cognizant of increased risk may in fact lower morbidity for patients undergoing TRUS-biopsy. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e438 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Aaron Lay Boston, MA More articles by this author Joshua Kaplan Boston, MA More articles by this author Stephen Williams Boston, MA More articles by this author Steven Chang Boston, MA More articles by this author Mike Siroky Boston, MA More articles by this author Ralph Orlando Boston, MA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...