MedWire News: The hospital admission rates for complications following transrectal ultrasound (TRUS)-guided prostate biopsy increased dramatically between 1996 and 2005 in Ontario, Canada, and this is primarily due to an increasing rate of infection-related complications, researchers report.
Robert Nam (Sunnybrook Research Institute, Toronto, Ontario, Canada) and colleagues conducted a population-based study of 75,190 men who underwent TRUS-guided biopsy in Ontario, Canada, between 1996 and 2005.
Among men who were not found to have prostate cancer, the hospital admission rate for urological complications within 30 days of the procedure was 1.9%. Further analysis showed that this rate had increased significantly from 1.0% in 1996 to 4.1% in 2005.
Most hospital admissions were for infection-related reasons (72%), followed by bleeding-related diagnoses (19%) and urinary obstruction-related diagnoses (9%).
The rate of hospital admissions related to infection increased from 0.6% in 1996 to 3.6% in 2005.
Among men diagnosed with prostate cancer, a smaller, although still significant, increase was seen in the 30-day hospital admission rate for urological complications, from 0.4% in 1996 to 0.9% in 2005 (p=0.002).
Nam et al comment in the Journal of Urology: “The rate was lower for patients with cancer because when those with prostate cancer were admitted to the hospital for biopsy-related complications, the coders for the Most Responsible Diagnosis could have assigned it as prostate cancer rather than the complication-related diagnoses.
“In addition, patients were likely to receive treatment for prostate cancer within 30 days of the biopsy, which also affected the accuracy of 30-day hospital admission rates.”
The researchers go on to say: “It is unclear why there is an increasing trend of hospital admission rates, particularly for infections.”
They note that men with underlying prostatitis, which would prompt a prostate biopsy due to falsely increased prostate specific antigen, may have been predisposed to exacerbated infection requiring hospital admission. Also, there may have been an increase in the average number of needle core samples obtained over time.
In an accompanying editorial, Janet Colli (University of Alabama, Birmingham, Alabama, USA) commented: “This study adds to the growing body of evidence supporting the need for the development of standardized prostate biopsy prophylaxis protocols, with overall goals of decreasing post-biopsy infectious complications.”
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