Complications after prostate biopsies in men on active surveillance and its effects on receiving further biopsies in the Prostate cancer Research International: Active Surveillance (PRIAS) study

Leonard P. Bokhorst, Inari Lepistö, Yoshiyuki Kakehi, Chris H. Bangma, Tom Pickles, Riccardo Valdagni, Arnout R. Alberts, Axel Semjonow, Petra Strölin, Manuel F. Montesino, Viktor Berge, Monique J. Roobol, Antti Rannikko

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Objective: To study the risk of serial prostate biopsies on complications in men on active surveillance (AS) and determine the effect of complications on receiving further biopsies. Patients and methods: In the global Prostate cancer Research International: Active Surveillance (PRIAS) study, men are prospectively followed on AS and repeat prostate biopsies are scheduled at 1, 4, and 7 years after the diagnostic biopsy, or once yearly if prostate-specific antigen-doubling time is <10 years. Data on complications after biopsy, including infection, haematuria, haematospermia, and pain, were retrospectively collected for all biopsies taken during follow-up in men from several large participating centres. Generalised estimating equations were used to test predictors of infection after biopsy. Competing risk analysis was used to compare the rates of men receiving further biopsies between men with and without previous complications. Results: In all, 2 184 biopsies were taken in 1 164 men. Infection was reported after 55 biopsies (2.5%), and one in five men reported any form of complication. At multivariable analysis, the number of previous biopsies was not a significant predictor of infection (odds ratio 1.04, 95% confidence interval 0.76–1.43). The only significant predictor for infection was the type of prophylaxis used. Of all men with a complication at the diagnostic or first repeat biopsy, 21% did not have a repeat biopsy at the time a repeat biopsy was scheduled according to protocol, vs 12% for men without a previous biopsy complication. Conclusion: In our present cohort of men on AS, we found no evidence that repeat prostate biopsy in itself posed a risk of infection. However, complications after biopsy were not uncommon and after a complication men were less likely to have further biopsies. We should aim to safely reduce the amount of repeat biopsies in men on AS.

Original languageEnglish
Pages (from-to)366-371
Number of pages6
JournalBJU International
Volume118
Issue number3
DOIs
Publication statusPublished - Sep 1 2016

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Prostate
Prostatic Neoplasms
Biopsy
Research
Infection
Hemospermia
Hematuria
Prostate-Specific Antigen

Keywords

  • active surveillance
  • biopsy
  • complication
  • infection
  • perineal
  • prostatic neoplasms

ASJC Scopus subject areas

  • Medicine(all)
  • Urology

Cite this

Complications after prostate biopsies in men on active surveillance and its effects on receiving further biopsies in the Prostate cancer Research International : Active Surveillance (PRIAS) study. / Bokhorst, Leonard P.; Lepistö, Inari; Kakehi, Yoshiyuki; Bangma, Chris H.; Pickles, Tom; Valdagni, Riccardo; Alberts, Arnout R.; Semjonow, Axel; Strölin, Petra; Montesino, Manuel F.; Berge, Viktor; Roobol, Monique J.; Rannikko, Antti.

In: BJU International, Vol. 118, No. 3, 01.09.2016, p. 366-371.

Research output: Contribution to journalArticle

Bokhorst, LP, Lepistö, I, Kakehi, Y, Bangma, CH, Pickles, T, Valdagni, R, Alberts, AR, Semjonow, A, Strölin, P, Montesino, MF, Berge, V, Roobol, MJ & Rannikko, A 2016, 'Complications after prostate biopsies in men on active surveillance and its effects on receiving further biopsies in the Prostate cancer Research International: Active Surveillance (PRIAS) study', BJU International, vol. 118, no. 3, pp. 366-371. https://doi.org/10.1111/bju.13410
Bokhorst, Leonard P. ; Lepistö, Inari ; Kakehi, Yoshiyuki ; Bangma, Chris H. ; Pickles, Tom ; Valdagni, Riccardo ; Alberts, Arnout R. ; Semjonow, Axel ; Strölin, Petra ; Montesino, Manuel F. ; Berge, Viktor ; Roobol, Monique J. ; Rannikko, Antti. / Complications after prostate biopsies in men on active surveillance and its effects on receiving further biopsies in the Prostate cancer Research International : Active Surveillance (PRIAS) study. In: BJU International. 2016 ; Vol. 118, No. 3. pp. 366-371.
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abstract = "Objective: To study the risk of serial prostate biopsies on complications in men on active surveillance (AS) and determine the effect of complications on receiving further biopsies. Patients and methods: In the global Prostate cancer Research International: Active Surveillance (PRIAS) study, men are prospectively followed on AS and repeat prostate biopsies are scheduled at 1, 4, and 7 years after the diagnostic biopsy, or once yearly if prostate-specific antigen-doubling time is <10 years. Data on complications after biopsy, including infection, haematuria, haematospermia, and pain, were retrospectively collected for all biopsies taken during follow-up in men from several large participating centres. Generalised estimating equations were used to test predictors of infection after biopsy. Competing risk analysis was used to compare the rates of men receiving further biopsies between men with and without previous complications. Results: In all, 2 184 biopsies were taken in 1 164 men. Infection was reported after 55 biopsies (2.5{\%}), and one in five men reported any form of complication. At multivariable analysis, the number of previous biopsies was not a significant predictor of infection (odds ratio 1.04, 95{\%} confidence interval 0.76–1.43). The only significant predictor for infection was the type of prophylaxis used. Of all men with a complication at the diagnostic or first repeat biopsy, 21{\%} did not have a repeat biopsy at the time a repeat biopsy was scheduled according to protocol, vs 12{\%} for men without a previous biopsy complication. Conclusion: In our present cohort of men on AS, we found no evidence that repeat prostate biopsy in itself posed a risk of infection. However, complications after biopsy were not uncommon and after a complication men were less likely to have further biopsies. We should aim to safely reduce the amount of repeat biopsies in men on AS.",
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AU - Lepistö, Inari

AU - Kakehi, Yoshiyuki

AU - Bangma, Chris H.

AU - Pickles, Tom

AU - Valdagni, Riccardo

AU - Alberts, Arnout R.

AU - Semjonow, Axel

AU - Strölin, Petra

AU - Montesino, Manuel F.

AU - Berge, Viktor

AU - Roobol, Monique J.

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N2 - Objective: To study the risk of serial prostate biopsies on complications in men on active surveillance (AS) and determine the effect of complications on receiving further biopsies. Patients and methods: In the global Prostate cancer Research International: Active Surveillance (PRIAS) study, men are prospectively followed on AS and repeat prostate biopsies are scheduled at 1, 4, and 7 years after the diagnostic biopsy, or once yearly if prostate-specific antigen-doubling time is <10 years. Data on complications after biopsy, including infection, haematuria, haematospermia, and pain, were retrospectively collected for all biopsies taken during follow-up in men from several large participating centres. Generalised estimating equations were used to test predictors of infection after biopsy. Competing risk analysis was used to compare the rates of men receiving further biopsies between men with and without previous complications. Results: In all, 2 184 biopsies were taken in 1 164 men. Infection was reported after 55 biopsies (2.5%), and one in five men reported any form of complication. At multivariable analysis, the number of previous biopsies was not a significant predictor of infection (odds ratio 1.04, 95% confidence interval 0.76–1.43). The only significant predictor for infection was the type of prophylaxis used. Of all men with a complication at the diagnostic or first repeat biopsy, 21% did not have a repeat biopsy at the time a repeat biopsy was scheduled according to protocol, vs 12% for men without a previous biopsy complication. Conclusion: In our present cohort of men on AS, we found no evidence that repeat prostate biopsy in itself posed a risk of infection. However, complications after biopsy were not uncommon and after a complication men were less likely to have further biopsies. We should aim to safely reduce the amount of repeat biopsies in men on AS.

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