PURPOSE: Transrectal ultrasound guided biopsy is the gold standard for detecting prostate cancer, but international reports have suggested increasing risks associated with the procedure.
We estimated incidence and risk factors for infection after prostate biopsy as well as 90-day mortality using a nationwide Swedish sample.
MATERIAL AND METHODS: We performed a population-based study between 2006 and 2011 of 51,321 men from the Prostate Cancer data Base (PCBaSe) Sweden. The primary outcome measures were dispensed prescriptions of antibiotics for urinary tract infection (UTI) and hospitalizations with a discharge diagnosis of a urinary tract infection. Multivariable logistic regression was used to examine risk factors for infection in men undergoing prostate biopsy.
RESULTS: During the 6 months prior to biopsy, the background incidence of urinary tract infection was approximately 2%. Within 30 days after biopsy, 6% had a dispensed prescription for urinary tract antibiotics and 1% were hospitalized with an infection. The strongest risk factors for an antibiotic prescription were prior infection (OR 1.59, 95% CI, 1.45-1.73), high Charlson comorbidity index (OR 1.25, 95% CI 1.11-1.41) and diabetes (OR 1.32, 95% CI 1.17-1.49). Risk of an antibiotic prescription after biopsy decreased from 2006 to 2011 (OR 0.79, 95% CI 0.70-0.90), whereas risk of hospital admission increased (OR 2.14, 95% CI 1.58-2.94). No significant increase in 90-day mortality was observed.
CONCLUSION: Severe infections with hospitalization after prostate biopsy are increasing in Sweden. The risk of post-biopsy infection is highest among men with a history of UTI and those with significant co-morbidities.
Written by:
Lundström KJ, Drevin L, Carlsson S, Garmo H, Loeb S, Stattin P, Bill-Axelson A. Are you the author?
Department of Surgical and Perioperative Sciences, Urology, Andrology, Umeå University, Östersund, Sweden; Regional Cancer Centre, Uppsala University Hospital, Uppsala, Sweden; Department of Molecular Medicine and Surgery, Section of Urology, Karolinska Institutet, Stockholm, Sweden; Department of Urology, New York University and the Manhattan Veterans Affairs Hospital, NY, NY, USA; Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
Reference: J Urol. 2014 May 6. pii: S0022-5347(14)03517-4.
doi: 10.1016/j.juro.2014.04.098
PubMed Abstract
PMID: 24813343
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