Department of Urology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
World J Urol. 2022 Sep;40(9):2261-2265. doi: 10.1007/s00345-022-04104-1. Epub 2022 Aug 5.
To compare infectious complications after transrectal systematic prostate biopsy (SB) and magnetic resonance imaging (MRI)-targeted biopsy (TB) in a large retrospective cohort to assess whether one technique is superior to the other regarding infectious complications.
A total of 4497 patients underwent 5288 biopsies, 2875 (54%) SB and 2413 (46%) MRI-TB only. On average, 12 SB cores and 3.7 MRI-TB cores were taken per biopsy session during the study period. Infection-related complications within 30 days were compared. The primary endpoint was a positive urine culture. Secondary endpoints were positive blood cultures, urine tests with elevated leukocytes ≥ 100 E6/L and elevated C-reactive protein (CRP) ≥ 100 mg/L. Chi-square test was used to compare the cohorts.
Positive urine cultures were found in 77 (2.7%) after SB and in 42 (1.7%) after MRI-TB (p = 0.022). In total, 46 (0.9%) blood culture positive infections were found, 23 (0.9%) occurred after SB and 23 (1.0%) after MRI-TB, (p = 0.848). Urine tests with elevated leukocytes ≥ 100 E6/L were found in 111 (3.9%) after SB and in 61 (2.5%) after MRI-TB (p = 0.006). Elevated CRP ≥ 100 mg/L was found in 122 (4.2%) after SB and in 72 (3.0%) after MRI-TB (p = 0.015). Blood cultures were drawn more often after SB than after MRI-TB, but the difference was not statistically significant. However, urine cultures and CRP were taken more often after SB than MRI-TB.
Blood culture positive infections were equally rare after SB and MRI-TB. However, all other infectious complications were more common after SB than MRI-TB.
通过比较经直肠系统前列腺活检（SB）和磁共振成像（MRI）靶向活检（TB）后的感染性并发症，在一个大型回顾性队列中评估这两种技术在感染性并发症方面是否存在差异。
共有 4497 名患者接受了 5288 次活检，其中 2875 次（54%）为 SB，2413 次（46%）为 MRI-TB。在研究期间，每次活检平均采集 12 个 SB 核心和 3.7 个 MRI-TB 核心。比较 30 天内与感染相关的并发症。主要终点是尿液培养阳性。次要终点是血培养阳性、白细胞计数≥100E6/L 的尿液检查和 C 反应蛋白（CRP）≥100mg/L 的尿液检查。采用卡方检验比较两组。
SB 后尿液培养阳性 77 例（2.7%），MRI-TB 后尿液培养阳性 42 例（1.7%）（p=0.022）。共发现 46 例（0.9%）血培养阳性感染，SB 后 23 例（0.9%），MRI-TB 后 23 例（1.0%）（p=0.848）。SB 后白细胞计数≥100E6/L 的尿液检查阳性 111 例（3.9%），MRI-TB 后 61 例（2.5%）（p=0.006）。SB 后 CRP≥100mg/L 的尿液检查阳性 122 例（4.2%），MRI-TB 后 72 例（3.0%）（p=0.015）。SB 后血培养的采集频率高于 MRI-TB，但差异无统计学意义。然而，SB 后尿液培养和 CRP 的采集频率高于 MRI-TB。
SB 和 MRI-TB 后血培养阳性感染同样罕见。然而，SB 后所有其他感染性并发症的发生率均高于 MRI-TB。
