Department of Urology, Dankook University College of Medicine, Cheonan, Korea.
J Korean Med Sci. 2018 Apr 6;33(17):e126. doi: 10.3346/jkms.2018.33.e126. eCollection 2018 Apr 23.
The prostate is prone to infections. Hypothetically, bacteria can be inoculated into the prostate during a transrectal prostate biopsy (TRPB) and progress into chronic bacterial prostatitis. Therefore, we examined new bacterial infections in biopsied prostates after TRPB and whether they affect clinical characteristics in the biopsied patients.
Of men whose prostate cultures have been taken prior to TRPB, 105 men with bacteria-free benign prostate pathology underwent an additional repeated prostate culture within a year after TRPB.
Twenty out of 105 men (19.05%) acquired new bacteria in their naïve prostates after TRPB. Except for one single case of infection, 19 men had acquired gram-positive bacteria species. Between the culture-positive and negative groups, there were no significant differences in age, serum prostate-specific antigen (PSA) level, white blood cell (WBC) counts in expressed prostatic secretion (EPS), prostate volume, symptom severities in Korean version of the National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) questionnaire, and patient-specific risk factors for biopsy associated infectious complications. Additionally, the TRPB procedure increased the WBC counts in post-biopsy EPS ( = 0.031, McNemar test), but did not increase the serum PSA level and symptoms of NIH-CPSI in 20 men who acquired new bacteria after TRPB.
The TRPB procedure was significantly associated with acquiring new bacterial infections in the biopsied prostate, but these localized bacteria did not affect patients' serum PSA level and symptoms after biopsy.
前列腺容易感染。理论上,在经直肠前列腺活检(TRPB)过程中,细菌可能会接种到前列腺中,并发展为慢性细菌性前列腺炎。因此,我们检查了 TRPB 后活检前列腺中新的细菌感染情况,以及它们是否会影响活检患者的临床特征。
在 TRPB 之前进行过前列腺培养的男性中,105 名无细菌良性前列腺病理患者在 TRPB 后一年内再次进行了额外的重复前列腺培养。
在 105 名男性中,有 20 名(19.05%)在 TRPB 后新的前列腺中获得了细菌。除了 1 例单一感染外,19 名男性获得了革兰阳性菌。在培养阳性和阴性组之间,年龄、血清前列腺特异性抗原(PSA)水平、前列腺分泌物(EPS)中的白细胞(WBC)计数、前列腺体积、韩国国立卫生研究院-慢性前列腺炎症状指数(NIH-CPSI)问卷中的症状严重程度以及与活检相关的感染性并发症的患者特定危险因素均无显著差异。此外,TRPB 程序增加了活检后 EPS 中的 WBC 计数(=0.031,McNemar 检验),但在 20 名 TRPB 后获得新细菌的男性中,并未增加血清 PSA 水平和 NIH-CPSI 症状。
TRPB 程序与活检前列腺中获得新的细菌感染显著相关,但这些局部细菌不会影响活检后患者的血清 PSA 水平和症状。