TRANSRECTAL ULTRASOUND GUIDED BIOPSY OF THE PROSTATE. DO ENEMAS DECREASE CLINICALLY SIGNIFICANT COMPLICATIONS?

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No AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 Jul 2001TRANSRECTAL ULTRASOUND GUIDED BIOPSY OF THE PROSTATE. DO ENEMAS DECREASE CLINICALLY SIGNIFICANT COMPLICATIONS? JEFFREY M. CAREY and HOWARD J. KORMAN JEFFREY M. CAREYJEFFREY M. CAREY More articles by this author and HOWARD J. KORMANHOWARD J. KORMAN More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)66082-XAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Purpose: Transrectal ultrasound guided biopsy of the prostate is the most common modality used to diagnose prostate cancer. Although many biopsy protocols have been described, in our opinion the role of enema before biopsy has not been definitively assessed in the literature. Materials and Methods: A retrospective review of 448 transrectal ultrasound guided biopsies was performed. All biopsies were done with the same equipment, and all patients received identical antibiotic prophylaxis with ciprofloxacin. There were 38 patients excluded from the study secondary to alternate antibiotic prophylaxis. A total of 225 patients received enemas before biopsy, while 185 did not. Clinically significant complications necessitating office visit, secondary therapy and hospitalization were evaluated. Results: Overall, clinically significant complications developed in 4.4% (10 of 225) of patients who had versus 3.2% (6 of 185) of those who did not have an enema (p = 0.614). There were 2 patients in each group who underwent transurethral prostatic resection or suprapubic prostatectomy for gross hematuria and/or urinary retention after biopsy. Of the patients who received enemas 2 were hospitalized for urinary retention and complicated urinary tract infection. One patient in the group without enema was hospitalized for gross hematuria and clot urinary retention. No patients who did not receive enema preparation were hospitalized for infectious complications. Conclusions: Transrectal ultrasound guided prostate biopsy accompanied by quinolone antibiotic prophylaxis remains a relatively safe procedure. Enema before biopsy provides no clinically significant outcome advantage, and potentially increases patient cost and discomfort. References 1 : Bacteremia and bacteriuria after transrectal prostatic biopsy. Urology1981; 18: 145. Google Scholar 2 : Prostate cancer detection in a clinical urological practice by ultrasonography, digital rectal exam and prostate specific antigen. J Urol1990; 143: 1146. Abstract, Google Scholar 3 : Systemic prostatic biopsies in 100 men with no suspicion of cancer on digital rectal examination. J Urol1991; 146: 1308. Abstract, Google Scholar 4 : Antibiotic prophylaxis in ultrasound guided transrectal prostate biopsy. J Urol1997; 157: 2199. 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Link, Google Scholar From the Department of Urology, William Beaumont Hospital, Royal Oak, Michigan© 2001 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byColeman S and Goldman H (2015) Antibiotic Stewardship in UrologyUrology Practice, VOL. 2, NO. 5, (270-274), Online publication date: 1-Sep-2015.Wolf J, Bennett C, Dmochowski R, Hollenbeck B, Pearle M and Schaeffer A (2008) Best Practice Policy Statement on Urologic Surgery Antimicrobial ProphylaxisJournal of Urology, VOL. 179, NO. 4, (1379-1390), Online publication date: 1-Apr-2008.MATLAGA B, ESKEW L and McCULLOUGH D (2018) Prostate Biopsy: Indications and TechniqueJournal of Urology, VOL. 169, NO. 1, (12-19), Online publication date: 1-Jan-2003.Griffith B, Morey A, Ali-Khan M, Canby-Hagino E, Foley J and Rozanski T (2018) Single Dose Levofloxacin Prophylaxis for Prostate Biopsy in Patients at Low RiskJournal of Urology, VOL. 168, NO. 3, (1021-1023), Online publication date: 1-Sep-2002. Volume 166Issue 1July 2001Page: 82-85 Advertisement Copyright & Permissions© 2001 by American Urological Association, Inc.KeywordsbiopsyprostateenemaultrasonographyMetricsAuthor Information JEFFREY M. CAREY More articles by this author HOWARD J. KORMAN More articles by this author Expand All Advertisement PDF downloadLoading ...