Complications of transperineal biopsy and the effect of antibiotic use: two-year experience at the Urology Department of Székesfehérvár Hospital
DOI: 10.22591/magyurol.2025.3.vargab.115
Authors:
Varga Bálint Ádám dr., Fekete Zoltán dr.
Fejér Vármegyei Szt. György Egyetemi Oktató Kórház, Urológiai Osztály, Székesfehérvár (osztályvezető: Fekete Zoltán dr.)
Summary
Introduction: Transperineal prostate biopsy is an increasingly utilized procedure in prostate cancer diagnostics. Investigation of complications arising during the procedure and the effectiveness of antibiotic use is crucial for patient safety (3). International studies show varying results regarding the effectiveness of antibiotic prophylaxis (2).
Methods: At the Urology Department of Székesfehérvár Hospital, 296 transperineal biopsies were performed between 2023 and 2025. Antibiotics were administered in some cases while not in others, with Betadine skin disinfection performed in all cases. We examined the frequency and nature of complications in both randomized groups.
Results: Antibiotics were administered in 114 patients. Pre-biopsy urine culture was positive in 26 cases, with complications occurring in 1 patient. Three cases (2.63%) presented to the emergency department with hematuria, none requiring hospital admission. Infectious complications occurred in 3 cases (2.63%) (including 1 positive urine culture patient with a double-J catheter), none requiring hospital admission, and urinary retention occurred in 2 cases (1.75%). In 182 cases, no antibiotics were used. Pre-biopsy urine culture was positive in 12 cases, with no complications in any of these patients. Seven cases (3.85%) presented to the emergency department with hematuria, with 1 requiring hospital admission due to disseminated intravascular coagulation (DIC). Infectious complications occurred in 2 cases (1.10%), none requiring hospital admission. Three cases (1.65%) presented with urinary retention, and percutaneous nephrostomy (PCN) insertion was necessary in 1 case (0.55%).
Discussion: International studies demonstrate that antibiotic prophylaxis does not always result in lower infection rates (3, 4). In our study, infection rates were 0.69% and 0.47% in the antibiotic-treated and non-treated groups respectively. Our results show lower infection rates without antibiotics (1.10%), consistent with international data.
Conclusion: Antibiotic prophylaxis during transperineal biopsy does not reduce complication rates. The effectiveness of antibiotics in transperineal biopsy remains unclear. Reducing antibiotic use is desirable to prevent the spread of antibiotic-resistant bacteria. Further research is necessary to determine optimal prophylaxis strategies.