Presentation Authors: KC Biebighauser Bens*, Dattatraya Patil, Lauren Kipling, Mark Henry, Christopher Filson, Atlanta, GA
Introduction: In response to rising risk of infectious complications following transrectal ultrasound guided prostate biopsies, advocates of transperineal prostate biopsy purport a near-zero risk of infectious complications and decreased need of periprocedural antibiotics compared to traditional transrectal prostate biopsy. This study aimed to evaluate the population-level incidence of complications after transperineal prostate biopsy.
Methods: Using a database on employer-based private insurance claims, we identified men less than 65 years old who underwent transperineal prostate biopsy (CPT 55706) from 2009 - 2015. Procedure and diagnosis codes were used to identify infectious, bleeding, and urinary retention complications associated with claims for hospitalization, emergency department (ED) and clinic visits within 30 days after transperineal prostate biopsy. Bivariate and multivariate analyses were performed to assess associations between outcomes of interest and pertinent patient covariates.
Results: We identified 2,206 claims for transperineal prostate biopsy episodes. 45.8% of patients were between 60-64 years old, 31.7% between 55-59, and 22.4% less than 55 years old. 50% of biopsies were performed in the Southern region of the United States. Within 30 days of biopsy, 4.9% of patients visited the ED and 1.1% of patients were hospitalized. Across all settings (hospital, ED, and clinic visits) infectious complications occurred in 4.7% of patients and urinary retention in 7.4% of patients. Overall, 2.3% of the episodes required cystoscopy with clot evacuation. After adjusting for other factors, age and prior diagnosis of diabetes were not significantly associated with any complication. Patients treated in a rural setting were more likely to have all forms of complications compared to patients treated in a metropolitan area (p value < 0.001).
Conclusions: Despite claims of minimal risk with transperineal prostate biopsy, complications of infection, urinary retention and bleeding occur. Future studies will assess the impact on biopsy approach and antibiotic management on these outcomes.
Source of Funding: American Cancer Society (MSRG-18-015-01-CPHPS for CPF)