Infectious Complications and Hospital Admissions After Prostate Biopsy in a European Randomized Trial

S Loeb, Suzanne Heuvel, XY Zhu, CH Bangma VERVALLEN, Fritz Schröder, Monique Roobol - Bouts

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Abstract

Background: The complications of prostate needle biopsy (PNB) are important when considering the benefits and harms of prostate cancer screening. Studies from the United States and Canada have recently reported increasing numbers of hospitalizations for infectious complications after PNB. Objective: Examine the risk of infectious complications and hospital admissions after PNB in a European screening trial. Design, setting, and participants: From 1993 to 2011, 10 474 PNBs were performed in the European Randomized Study of Screening for Prostate Cancer (Rotterdam section). Prophylaxis originally consisted of trimethoprim-sulfamethoxazole. Beginning in 2008, it was changed to ciprofloxacin. Measurements: Febrile complications and hospital admissions were assessed by questionnaires 2 wk after PNB. Logistic regression was used to identify risk factors for biopsy-related fever and hospital admission. Results and limitations: Fever and hospital admission were reported on 392 of 9241 questionnaires (4.2%) and 78 of 9198 questionnaires (0.8%), respectively. Although most fevers were managed on an outpatient basis, 81% of hospital admissions were for infection. Of the 56 available blood cultures, 34 were positive with Escherichia coli as the predominant organism. On multivariable analysis, prostate enlargement and diabetes were significantly associated with an increased risk of fever after PNB, Conclusions: In a European screening trial, <5% PNBs resulted in febrile complications. Significant risk factors included diabetes and prostatic enlargement. Although most fevers were managed on an outpatient basis, infection remained the leading cause of hospital admission after PNB. Consistent with prior international reports, the frequency of hospital admissions after PNB significantly increased over time. Nevertheless, the absolute frequency of hospital admissions related to PNB was low and
Original languageUndefined/Unknown
Pages (from-to)1110-1114
Number of pages5
JournalEuropean Urology
Volume61
Issue number6
DOIs
Publication statusPublished - 2012

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