Introduction:Infections are the most feared complication of transrectal prostate biopsies,along with growing concerns of antibiotic resistance.Our institution transitioned to a transperineal approach without use of pe...Introduction:Infections are the most feared complication of transrectal prostate biopsies,along with growing concerns of antibiotic resistance.Our institution transitioned to a transperineal approach without use of perioperative antibiotics or bowel preparations.We aimed to compare the safety outcomes associated with transperineal and transrectal prostate biopsy techniques.Materials and Methods:A retrospective analysis of patients who underwent transrectal and transperineal prostate biopsies at our institution from 2019–2022 was performed.Results:We identified 319 patients—174 transrectal and 145 transperineal.8 patients who had transperineal biopsy(5.5%)received peri-operative antibiotics,compared to 100%with transrectal biopsy.35.86%of transperineal patients received a bowel preparation,compared to 100%in the transrectal group.44.14%and 49.43%of patients received a prior prostate biopsy in the transperineal and transrectal groups,respectively.Patients in the transperineal biopsy group had zero infectious complications,1 ER visit,and zero 30-day readmissions.This is compared to 9 infectious complications(5.17%,p=0.005),8 ER visits(4.60%,p=0.036),and 730-day readmissions(4.02%,p=0.015)in the transrectal group.Conclusions:In a single institution series,patients undergoing transperineal biopsy had fewer infectious complications compared to those undergoing transrectal biopsy.Despite only a small percentage of patients receiving perioperative antibiotics and a majority of patients not receiving a bowel preparation in the transperineal group,there were zero infectious complications or 30-day readmissions.With greater infectious complications with transrectal biopsy and growing antibiotic resistance,we underline the safety of transperineal prostate biopsy which can largely be done without perioperative antibiotics or a bowel preparation.展开更多
基金the Cancer Institute of New Jersey is supported by a grant from the National Cancer Institute:P30CA072720Arnav Srivastava is supported by a training grant from the National Cancer Institute:T32CA180984.
文摘Introduction:Infections are the most feared complication of transrectal prostate biopsies,along with growing concerns of antibiotic resistance.Our institution transitioned to a transperineal approach without use of perioperative antibiotics or bowel preparations.We aimed to compare the safety outcomes associated with transperineal and transrectal prostate biopsy techniques.Materials and Methods:A retrospective analysis of patients who underwent transrectal and transperineal prostate biopsies at our institution from 2019–2022 was performed.Results:We identified 319 patients—174 transrectal and 145 transperineal.8 patients who had transperineal biopsy(5.5%)received peri-operative antibiotics,compared to 100%with transrectal biopsy.35.86%of transperineal patients received a bowel preparation,compared to 100%in the transrectal group.44.14%and 49.43%of patients received a prior prostate biopsy in the transperineal and transrectal groups,respectively.Patients in the transperineal biopsy group had zero infectious complications,1 ER visit,and zero 30-day readmissions.This is compared to 9 infectious complications(5.17%,p=0.005),8 ER visits(4.60%,p=0.036),and 730-day readmissions(4.02%,p=0.015)in the transrectal group.Conclusions:In a single institution series,patients undergoing transperineal biopsy had fewer infectious complications compared to those undergoing transrectal biopsy.Despite only a small percentage of patients receiving perioperative antibiotics and a majority of patients not receiving a bowel preparation in the transperineal group,there were zero infectious complications or 30-day readmissions.With greater infectious complications with transrectal biopsy and growing antibiotic resistance,we underline the safety of transperineal prostate biopsy which can largely be done without perioperative antibiotics or a bowel preparation.
