Bacteremia and bacteriuria after transrectal ultrasound guided prostate biopsy

被引:129
作者
Lindert, KA
Kabalin, JN
Terris, MK
机构
[1] Vet Affairs Palo Alto Hlth Care Syst, Sect Urol 112 C, Palo Alto, CA 94304 USA
[2] Stanford Univ, Med Ctr, Dept Urol, Stanford, CA 94305 USA
[3] Univ Nebraska, Coll Med, Sect Urol Surg, Scottsbluff, NE USA
关键词
prostate; bacteremia; bacteriuria; biopsy; infection;
D O I
10.1016/S0022-5347(05)67453-8
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Purpose: We determined the incidence and predisposing factors of bacteremia and bacteriuria after prostate biopsy with specific emphasis on the value of a pre-biopsy enema. Materials and Methods: We randomized 50 men undergoing ultrasound and biopsy to rule out prostate cancer to receive a preoperative (25) or no (25) enema. Preoperatively urine was obtained for culture, and questionnaires regarding urological history and voiding symptoms were completed. The initial prostate biopsy, biopsy needle, and postoperative urine and blood specimens were cultured. The following day a symptom questionnaire was completed. Results: Bacterial growth in post-procedure cultures did not correlate with the number of biopsies, prostate specific antigen, obstructive voiding symptoms, prostate volume, cancer or post-biopsy hematuria. Bacteriuria was noted in 44% of the cases and bacteremia was present in 16% of the patients, of whom 87.5% did not receive an enema (p = 0.0003). Only 1 patient had chills and fever greater than 37.5C, requiring additional antibiotics. On the followup questionnaire 12% of patients described dysuria, including 84% with bacteriuria after biopsy. Conclusions: Bacteremia and bacteriuria after multiple biopsies are common but usually asymptomatic. Bacteria is apparently introduced into the urine and/or blood from the rectum via the biopsy needle, which may be minimized by a pre-biopsy enema. Dysuria or a history of urinary tract infection did not predict problems after biopsy.
引用
收藏
页码:76 / 80
页数:5
相关论文
共 23 条
[11]  
MELEKOS M D, 1990, International Urology and Nephrology, V22, P257, DOI 10.1007/BF02550403
[12]  
Nava Luciano, 1997, Journal of Urology, V157, P59
[13]   POVIDONE-IODINE ANTISEPSIS FOR TRANS-RECTAL PROSTATIC BIOPSY [J].
REES, M ;
ASHBY, EC ;
POCOCK, RD ;
DOWDING, CH .
BRITISH MEDICAL JOURNAL, 1980, 281 (6241) :650-650
[14]   DOUBLE-BLIND-STUDY OF TRIMETHOPRIMSULFAMETHOXAZOLE PROPHYLAXIS IN PATIENTS HAVING TRANS-RECTAL NEEDLE-BIOPSY OF THE PROSTATE [J].
RUEBUSH, TK ;
MCCONVILLE, JH ;
CALIA, FM .
JOURNAL OF UROLOGY, 1979, 122 (04) :492-494
[15]   Use of three additional mid biopsies to improve local assessment of prostate cancer in patients with one positive sextant biopsy [J].
Salomon, L ;
Colombel, M ;
Patard, JJ ;
Bellot, J ;
Chopin, DK ;
Abbou, CC .
EUROPEAN UROLOGY, 1998, 34 (04) :313-317
[16]   Variability in patient preparation for prostate biopsy among American urologists [J].
Shandera, KC ;
Thibault, GP ;
Deshon, GE .
UROLOGY, 1998, 52 (04) :644-646
[17]   Efficacy of one dose fluoroquinolone before prostate biopsy [J].
Shandera, KC ;
Thibault, GP ;
Deshon, GE .
UROLOGY, 1998, 52 (04) :641-643
[18]   URINARY-TRACT INFECTION AFTER TRANS-RECTAL NEEDLE-BIOPSY OF THE PROSTATE [J].
SHARPE, JR ;
SADLOWSKI, RW ;
FINNEY, RP ;
BRANCH, WT ;
HANNA, JE .
JOURNAL OF UROLOGY, 1982, 127 (02) :255-256
[19]   Comparison of mid-lobe versus lateral systematic sextant biopsies in the detection of prostate cancer [J].
Terris, MK ;
Wallen, EM ;
Stamey, TA .
UROLOGIA INTERNATIONALIS, 1997, 59 (04) :239-242
[20]   EFFICACY OF TRANSRECTAL ULTRASOUND-GUIDED SEMINAL-VESICLE BIOPSIES IN THE DETECTION OF SEMINAL-VESICLE INVASION BY PROSTATE-CANCER [J].
TERRIS, MK ;
MCNEAL, JE ;
FREIHA, FS ;
STAMEY, TA .
JOURNAL OF UROLOGY, 1993, 149 (05) :1035-1039