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Title: Sepsis and 'superbugs': should we favour the transperineal over the transrectal approach for prostate biopsy?
Epworth Authors: Grummet, Jeremy
Lawrentschuk, Nathan
Frydenberg, Mark
Moon, Daniel
Murphy, Declan
Other Authors: Weerakoon, Mahesha
Huang, Sean
O'Reilly, Mary
Keywords: Infection
Transperineal Biopsy
Transrectal Biopsy
Epworth Healthcare, Melbourne, VIC, Australia
Transrectal Ultrasonography
TRUS Biopsy
TP Biopsy
Issue Date: Sep-2014
Citation: BJU Int. 2014 Sep;114(3):384-8
Abstract: OBJECTIVE: To determine the rate of hospital re-admission for sepsis after transperineal (TP) biopsy using both local data and worldwide literature, as there is growing interest in TP biopsy as an alternative to transrectal ultrasonography (TRUS)-guided biopsy for patients undergoing repeat prostate biopsy. PATIENTS AND METHODS: Pooled prospective databases on TP biopsy from multiple centres in Melbourne were queried for rates of re-admission for infection. A literature review of PubMed and Embase was also conducted using the search terms: 'prostate biopsy, fever, infection, sepsis, septicaemia and complications'. RESULTS: In all, 245 TP biopsies were performed (111 at Alfred Health, 92 at Epworth Healthcare, 38 at Peter MacCallum Cancer Centre, and four at other institutions). The rate of hospital re-admission for infection was zero. The literature review showed that the rate of sepsis after TRUS biopsy appears to be rising with increasing rates of multi-resistant bacteria found in rectal flora, and is as high as 5%. However, the rate of sepsis from published series of TP biopsy approached zero. CONCLUSIONS: Both local and international data suggest a negligible rate of sepsis with TP biopsy. This compares to a concerning rise in the rate of sepsis after TRUS biopsy due to the increasing prevalence of multi-resistant bacteria in rectal flora. Although TRUS biopsy is convenient, cheap and quick to perform, we think that TP biopsy should now be offered as an option, not only to patients undergoing repeat prostate biopsy, but to all patients in whom a prostate biopsy is indicated.
DOI: 10.1111/bju.12536
PubMed URL:
ISSN: 1464-4096
Journal Title: BJU International
Type: Journal Article
Affiliated Organisations: Australian Urology Associates
Peter MacCallum Cancer Institute, Melbourne, VIC, Australia
Cabrini Health, Melbourne, VIC, Australia
Eastern Health Clinical School, Melbourne, VIC, Australia
Monash University, Melbourne, VIC, Australia
Appears in Collections:Cancer Services
UroRenal, Vascular
Epworth Prostate Centre

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