Poster, Podium & Video Sessions
Presentation Authors: José Cadilhe*, Viana do Castelo, Portugal
Introduction: 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.
Source Of Funding: none
Universidade do Minho
José Pedro Cadilhe, MD, FEBU
ULSAM- Unidade Local de Saúde do Alto Minho - Hospital de Viana do Castelo
UNIVERSIDADE do Minho - Braga
Author of several papers published in National (17) and Foreign (11) journals, namely in the Portuguese Urological Act, the British Journal of Urology (BJU), the Journal of Endourology, European Urology Today and Urology.
Invited speaker at several events in the field of urology, and presented numerous works as an author both in Portugal and abroad (14 free communications, 6 videos, 39 posters).