Packer M G, Russo P, Fair W R
J Urol. 1984 Apr;131(4):687-9. doi: 10.1016/s0022-5347(17)50580-7.
We studied retrospectively 162 patients undergoing transperineal needle biopsy of the prostate. All patients had urine cultures before biopsy. Patients were divided into 4 groups: group 1--no antibiotics (44), group 2--antibiotics before and after biopsy (69), group 3--antibiotics after biopsy only (42) and group 4--antibiotics before biopsy only (7). Groups were similar in average age (65 years) and pathologic diagnosis (prostatic cancer in 28 per cent and a benign prostate in 72 per cent). Of the 162 patients 4 (2.5 per cent) had positive urine cultures preoperatively. Post-biopsy urine cultures were obtained in 86 patients and 2 (2 per cent) were positive. Only 12 patients (11 per cent) required catheters for postoperative urinary retention. Complications occurred in 9 patients (5.5 per cent): 7 (4.3 per cent) had febrile episodes, 1(0.6 per cent) had a documented postoperative urinary tract infection and 1(0.6 per cent) sustained a large pelvic hematoma. No statistically significant difference could be found among the 4 groups in regard to complication rate. This study demonstrates no advantage to the routine use of antibiotics or Foley catheters in transperineal needle biopsy of the prostate, provided the urine is sterile before biopsy. Cost analysis of these data demonstrates a considerable savings when routine antibiotics and Foley catheters are not used.
我们回顾性研究了162例行经会阴前列腺穿刺活检的患者。所有患者在活检前均进行了尿培养。患者被分为4组：第1组——不使用抗生素（44例），第2组——活检前后均使用抗生素（69例），第3组——仅在活检后使用抗生素（42例），第4组——仅在活检前使用抗生素（7例）。各组患者的平均年龄（65岁）和病理诊断相似（28%为前列腺癌，72%为良性前列腺）。162例患者中，4例（2.5%）术前尿培养呈阳性。86例患者进行了活检后尿培养，其中2例（2%）呈阳性。仅12例患者（11%）因术后尿潴留需要留置导尿管。9例患者（5.5%）出现并发症：7例（4.3%）有发热症状，1例（0.6%）有记录在案的术后尿路感染，1例（0.6%）发生了盆腔大出血。4组之间在并发症发生率方面未发现统计学上的显著差异。本研究表明，在经会阴前列腺穿刺活检中，只要活检前尿液无菌，常规使用抗生素或Foley导尿管并无优势。对这些数据的成本分析表明，不使用常规抗生素和Foley导尿管可节省大量费用。
