Zero hospital admissions for infection after 1024 transperineal prostate biopsies.

Abstract

INTRODUCTION & PURPOSE: Transperineal biopsy (TPB) has been associated with an exceedingly low rate of serious infection. The aim of this study was to determine the rate of hospital admissions for infection after transperineal biopsy of prostate. MATERIALS & METHODS: A total of 1061 consecutive patients underwent transperineal biopsy of the prostate (TPB) between May 2012 and April 2016 by a private group urology practice, performing TPB at multiple hospitals across Melbourne. They had various antibiotic prophylaxis regimes. Data collected from these patients were entered into an ethics approved prospective database including prophylactic antibiotics used and post-operative complications. RESULTS: A total of 1061 consecutive patients underwent TPB. Initially patients were treated with quinolone prophylaxis and then later 594 consecutive patients received cephazolin only. None were readmitted to hospital with infection. Seven patients developed acute urinary retention and one patient was treated in the community with oral antibiotics for prostatitis. CONCLUSION: Sepsis post-TPB is an exceedingly rare complication, with a 0% rate in this study. It is safe to use single-dose cephazolin only as antibiotic prophylaxis prior to TPB, negating the need for quinolones. This study supports the current Therapeutic Guidelines recommendation for TPB prophylaxis. Whether any antibiotic prophylaxis is needed at all for TPB is the subject of a future study.