Is Urine Culture Routinely Necessary Before Prostate Biopsy?
Is Urine Culture Routinely Necessary Before Prostate Biopsy?
The objective of this study was to assess the value of a urine bacterial culture performed before prostate biopsy. We performed a prospective study on 353 patients who underwent prostate biopsy. All patients had a urine bacterial culture performed before biopsy. We compared the outcomes of patients with bacteriuria (left untreated) with those of patients without bacteriuria. Of the 353 men, 12 had a pre-biopsy-positive bacterial culture and underwent prostate biopsy without any infectious complication. Fifteen patients with a negative pre-biopsy culture developed a post-biopsy-positive bacterial culture, but remained asymptomatic without any treatment. Only four men from the group without pre-biopsy bacteriuria developed an infectious complication, requiring 3 weeks of antibiotic therapy. The complication rates were similar for both groups. Our results suggest that routine urine bacterial culture before prostate biopsy is not useful when antibiotic prophylaxis and enema are performed. We do, however, suggest performing a urine bacterial culture before prostate biopsy for patients with a previous history of urinary tract infections.
Transrectal needle biopsy procedure is one of the most common procedures performed by urologists. Although it is considered to be safe, post-biopsy sepsis is commonly seen in practice. Infection reports vary across studies, and even if it is considered to be consensual, the use of antibiotic prophylaxis varies between institutions. In the literature, bacteriuria is seen in 20–53% and prostatitis in 0.6–4% of the transrectal prostate biopsies. Urine bacterial culture before prostate biopsy has been performed by many institutions without proof of real benefit. As the bacteria are apparently introduced into the urine and/or blood from the rectum, we found that the routine urine culture is unnecessary before prostate biopsy. In our institution, the prostatitis rate after prostate biopsy is between 1 and 3% and is similar to the rates reported in the literature. We performed a prospective study to assess the value of urine bacterial culture performed before prostate biopsy.
Abstract and Introduction
Abstract
The objective of this study was to assess the value of a urine bacterial culture performed before prostate biopsy. We performed a prospective study on 353 patients who underwent prostate biopsy. All patients had a urine bacterial culture performed before biopsy. We compared the outcomes of patients with bacteriuria (left untreated) with those of patients without bacteriuria. Of the 353 men, 12 had a pre-biopsy-positive bacterial culture and underwent prostate biopsy without any infectious complication. Fifteen patients with a negative pre-biopsy culture developed a post-biopsy-positive bacterial culture, but remained asymptomatic without any treatment. Only four men from the group without pre-biopsy bacteriuria developed an infectious complication, requiring 3 weeks of antibiotic therapy. The complication rates were similar for both groups. Our results suggest that routine urine bacterial culture before prostate biopsy is not useful when antibiotic prophylaxis and enema are performed. We do, however, suggest performing a urine bacterial culture before prostate biopsy for patients with a previous history of urinary tract infections.
Introduction
Transrectal needle biopsy procedure is one of the most common procedures performed by urologists. Although it is considered to be safe, post-biopsy sepsis is commonly seen in practice. Infection reports vary across studies, and even if it is considered to be consensual, the use of antibiotic prophylaxis varies between institutions. In the literature, bacteriuria is seen in 20–53% and prostatitis in 0.6–4% of the transrectal prostate biopsies. Urine bacterial culture before prostate biopsy has been performed by many institutions without proof of real benefit. As the bacteria are apparently introduced into the urine and/or blood from the rectum, we found that the routine urine culture is unnecessary before prostate biopsy. In our institution, the prostatitis rate after prostate biopsy is between 1 and 3% and is similar to the rates reported in the literature. We performed a prospective study to assess the value of urine bacterial culture performed before prostate biopsy.
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