Complications after systematic, random, and image-guided prostate biopsy

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Title: Complications after systematic, random, and image-guided prostate biopsy
Author(s): Borghesi, M
Ahmed, H
Nam, R
Schaeffer, E
Schiavina, R
Taneja, S
Weidner, W
Loeb, S
Item Type: Journal Article
Abstract: Context Prostate biopsy (PB) represents the gold standard method to confirm the presence of cancer. In addition to traditional random or systematic approaches, a magnetic resonance imaging (MRI)–guided technique has been introduced recently. Objective To perform a systematic review of complications after transrectal ultrasound (TRUS)–guided, transperineal, and MRI-guided PB. Evidence acquisition We performed a systematic literature search of Web of Science, Embase, and Scopus databases up to October 2015, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Complications and mortality following random, systematic, and image-guided PBs were reviewed. Eighty-five references were included. Evidence synthesis The most frequent complication after PB was minor and self-limiting bleeding (hematuria and hematospermia), regardless of the biopsy approach. Occurrence of rectal bleeding was comparable for traditional TRUS-guided and image-guided PBs. Almost 25% of patients experienced lower urinary tract symptoms, but only a few had urinary retention, with higher rates after a transperineal approach. Temporary erectile dysfunction was not negligible, with a return to baseline after 1–6 mo. The incidence of infective complications is increasing, with higher rates among men with medical comorbidities and older age. Transperineal and in-bore MRI–targeted biopsy may reduce the risk of severe infectious complications. Mortality after PB is uncommon, regardless of biopsy technique. Conclusions Complications after PB are frequent but often self-limiting. The incidence of hospitalization due to severe infections is continuously increasing. The patient's general health status, risk factors, and likelihood of antimicrobial resistance should be carefully appraised before scheduling a PB.
Publication Date: 17-Aug-2016
Date of Acceptance: 3-Aug-2016
URI: http://hdl.handle.net/10044/1/53868
DOI: https://dx.doi.org/10.1016/j.eururo.2016.08.004
ISSN: 0302-2838
Publisher: Elsevier
Start Page: 353
End Page: 365
Journal / Book Title: European Urology
Volume: 71
Issue: 3
Copyright Statement: © 2016 European Association of Urology. Published by Elsevier B.V. All rights reserved.
Keywords: Science & Technology
Life Sciences & Biomedicine
Urology & Nephrology
Prostate biopsy
Complications
MRI-guided biopsy
Infection
Hospitalization
Mortality
PERIPROSTATIC NERVE BLOCK
IMPROVES PAIN-CONTROL
LOW-DOSE ASPIRIN
QUALITY-OF-LIFE
INFECTIOUS COMPLICATIONS
ANTIMICROBIAL PROPHYLAXIS
ERECTILE FUNCTION
ANTIBIOTIC-PROPHYLAXIS
HOSPITAL ADMISSIONS
ACTIVE SURVEILLANCE
Complications
Hospitalization
Infection
MRI-guided biopsy
Mortality
Prostate biopsy
Science & Technology
Life Sciences & Biomedicine
Urology & Nephrology
Prostate biopsy
Complications
MRI-guided biopsy
Infection
Hospitalization
Mortality
PERIPROSTATIC NERVE BLOCK
IMPROVES PAIN-CONTROL
LOW-DOSE ASPIRIN
QUALITY-OF-LIFE
INFECTIOUS COMPLICATIONS
ANTIMICROBIAL PROPHYLAXIS
ERECTILE FUNCTION
ANTIBIOTIC-PROPHYLAXIS
HOSPITAL ADMISSIONS
ACTIVE SURVEILLANCE
1103 Clinical Sciences
Urology & Nephrology
Publication Status: Published
Appears in Collections:Division of Surgery
Faculty of Medicine



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