MP11-17 TRANSRECTAL PROSTATE BIOPSY AFTER PROPHYLATIC PREPARATION OF THE RECTUM WITH POVIDONE-IODINE – A PROSPECTIVE RANDOMIZED TRIAL

Abstract

You have accessJournal of UrologyInfections/Inflammation/Cystic Disease of the Genitourinary Tract: Prostate & Genitalia II1 Apr 2017MP11-17 TRANSRECTAL PROSTATE BIOPSY AFTER PROPHYLATIC PREPARATION OF THE RECTUM WITH POVIDONE-IODINE – A PROSPECTIVE RANDOMIZED TRIAL José Cadilhe José CadilheJosé Cadilhe More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.418AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Transrectal ultrasound (TRUS) guided prostate biopsy can lead to urinary tract infections in up to 11% and sepsis in up to 2% of patients. We evaluate whether an original way to apply peri-procedure povidone-iodine rectal preparation prior to TRUS-guided prostate needle biopsy can reduce infectious complications. METHODS Between january/2014 and september/2016, 94 men in private office were prospectively randomized to rectal cleansing (an original transrectal prostate massage for about half a minute with 2,5ml of betadine100 mg/ml) (47) or no cleansing (47) before TRUS guided prostate biopsy with periprostatic local injection of lidocaine. All of the patients received prophylactic antibiotics: levofloxacine 500mg PO for 7 days, beginning the day before procedure. Patients completed a telephone interview 4 days after undergoing the biopsy and went to doctor office 2 weeks after biopsy. The primary end point was the rate of infectious complications, a composite end point of 1 or more of 1) fever greater than 38.0C, 2) urinary tract infection or 3) sepsis (standardized definition). RESULTS Infectious complications developed in 6 cases (11%) in the non rectal preparation group: one patient had sepsis (2%) and five had fever without sepsis. In the povidone-iodine rectal preparation group we had no infectious complication (0,0%). Of the 94 men who underwent TRUS guided biopsy 45 (47.9%) were diagnosed with prostate cancer and 3 (3,2%) had ASAP in the result. The hospital admission rate for urological complications within 30 days of the procedure was 1%, and only for infection related reasons (sepsis). CONCLUSIONS The administration of quinolone-based prophylactic antibiotics and the simple use of 2,5 ml of povidone-iodine solution in a transrectal prostate massage for about half a minute provided an excellent protocol for reducing infective complications of TRUS-guided prostate biopsy. The simplicity of these method and cost effectiveness of betadine100 mg/ml were noteworthy, with statistically significant relative risk reduction of infectious complications in this study. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e143 Advertisement Copyright & Permissions© 2017MetricsAuthor Information José Cadilhe More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...