Yildirim Mehmet Erol, Badem Huseyin, Cavis Mucahit, Karatas Omer Faruk, Cimentepe Ersin, Unal Dogan, Incebay Ilkay Bekir
Turgut Ozal University School of Medicine Department of Urology, Ankara, Turkey.
Yüksek İhtisas Training and Research Hospital Department of Urology, Ankara, Turkey.
Cent European J Urol. 2015;68(1):91-4. doi: 10.5173/ceju.2015.01.424. Epub 2015 Jan 23.
Transrectal ultrasonography (TRUS) guided prostate needle biopsy has been performed to diagnose and stage prostate cancer for many years. There are many different bowel preparation protocols to diminish the infectious complications, but there is no standardized consensus among urologists. Therefore, we aimed to assess two different bowel preparation methods on the rate of infectious complications in patients who underwent TRUS-guided prostate biopsy.
A total of 387 cases of TRUS-guided prostate biopsy were included in this retrospective study. All patients received antibiotic prophylaxis with ciprofloxacin (500 mg) twice a day orally for 7 days starting on the day before the biopsy. The patients were divided into two groups according to the bowel preparation method used. Patients (Group 1, n = 164) only received self-administrated phosphate enema) on the morning of the prostate biopsy. Other patients (Group 2, n = 223) received sennasoid a-b laxatives the night before the prostate biopsy. Infectious complications were classified as sepsis, fever (greater than 38°C) without sepsis, and other clinical infections.
Major complications developed in 14 cases (3.8%), including 3 cases (0.8%) of urinary retention, and 11 (3%) infectious complications, all of which were sepsis. There were 3 and 8 cases of urosepsis in Group 1 and Group 2, respectively. There were no statistically significant differences between both Groups regarding to the rates of urosepsis (p = 0.358).
Despite both methods of bowel preparation, sodium phosphate enema or sennasoid a-b calcium laxatives, before TRUS-guided prostate biopsy have similar effect on the rate of urosepsis, so both methods of bowel preparation can be safely used.
经直肠超声（TRUS）引导下的前列腺穿刺活检多年来一直用于诊断和分期前列腺癌。为减少感染并发症，有多种不同的肠道准备方案，但泌尿外科医生之间尚无标准化的共识。因此，我们旨在评估两种不同的肠道准备方法对接受TRUS引导下前列腺活检患者感染并发症发生率的影响。
本回顾性研究共纳入387例TRUS引导下的前列腺活检病例。所有患者在活检前一天开始口服环丙沙星（500毫克），每日两次，共7天进行抗生素预防。根据所采用的肠道准备方法将患者分为两组。患者（第1组，n = 164）仅在前列腺活检当天早晨接受自行使用的磷酸盐灌肠。其他患者（第2组，n = 223）在前列腺活检前一晚接受含番泻叶的a - b缓泻剂。感染并发症分为败血症、无败血症的发热（体温高于38°C）和其他临床感染。
14例（3.8%）出现主要并发症，包括3例（0.8%）尿潴留和11例（3%）感染并发症，均为败血症。第1组和第2组分别有3例和8例尿脓毒症。两组在尿脓毒症发生率方面无统计学显著差异（p = 0.358）。
尽管在TRUS引导下前列腺活检前使用磷酸钠灌肠或含番泻叶的a - b钙缓泻剂这两种肠道准备方法对尿脓毒症发生率的影响相似，但两种肠道准备方法均可安全使用。
