Update on techniques to prevent infections associated with prostate needle biopsy

Matteo Fontana, Luca Boeri, Emanuele Montanari

Research output: Contribution to journalReview article

Abstract

Purpose of review Postbiopsy infections (PBIs) are among the most common complications associated with transrectal ultrasound-guided prostate biopsy (TRUSPB). This article discusses the pathogenesis of TRUSPB-associated infectious complications and reviews the most recent findings on techniques to prevent PBIs. Recent findings Risk stratification is a powerful tool for identifying TRUSPB candidates whom warrant additional preventive measures. Bowel preparation with povidone-iodine-based enemas and needle disinfection with formalin solution are simple and attractive strategies, but their effectiveness needs to be thoroughly assessed. Antibiotic prophylaxis represents the mainstay for the prevention of PBIs: the prophylactic regimen must respect the principles of antimicrobial stewardship, and local antibiotic resistance patterns among uropathogens should always be considered. Augmented and targeted antibiotic prophylaxes are powerful options, but their role in current clinical practice has yet to be clarified. The transperineal approach has shown a near-zero rate of PBIs, and should therefore be considered for the highest-risk patients. Summary Several procedures have been introduced to prevent TRUSPB-related infectious complication, but their utility and applicability in the clinical practice has yet to be elucidated. More robust evidence based on randomized control trials is needed to establish the efficacy of these tools in improving patient outcomes.

Original languageEnglish
Pages (from-to)392-397
Number of pages6
JournalCurrent Opinion in Urology
Volume28
Issue number4
DOIs
Publication statusPublished - Jul 1 2018

Keywords

  • antimicrobial resistance
  • infectious complications
  • prevention
  • transrectal ultrasound-guided prostate needle biopsy

ASJC Scopus subject areas

  • Urology

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