MP53-18: zero sepsis in 608 consecutive transperineal prostate biopsies.

Abstract

INTRODUCTION AND OBJECTIVES: Sepsis has always been a concern in the traditional transrectal ultrasound (TRUS) guided biopsy of the prostate. However, rates of sepsis following TRUS biopsy have shown to be increasing around the world in addition to the emergence of multiresistant organisms found in rectal flora. As a result, our practice of seven Urologists has switched to transperineal (TP) biopsy. We aim to determine the rate of hospital re-admission in our patients undergoing TP biopsy. METHODS: An ethics approved prospective database of all men undergoing TP biopsy at our practice has been kept including antibiotics used as well as re-admission for infection. RESULTS: A total of 608 TP biopsies were performed between May 2012 and March 2015. Patient demographics include a mean age of 63.5 years (range 41-87), mean PSA of 10.9 (range 0.2 – 83.6) and mean cores taken 25.8 (range 14-36). A total of 538 patients had documented antibiotic usage. Of these, 66.7% (358 patients) received cephazolin only and 31.5% (169 patients) received a fluoroquinolone only. The remaining patients received either a combination of these or another antibiotic. There were no re-admissions for sepsis. CONCLUSIONS: Our data suggests a negligible rate of sepsis with TP biopsy. Furthermore, the use of a single dose of cephalosporin may limit the further development of multiresistant bacteria. Whilst there are other benefits of TP biopsy including increased detection rates and the possibility of MRI fusion, the negligible rate of sepsis alone may be enough to use TP biopsy rather than TRUS biopsy.