Journal List > Korean J Urol > v.49(3) > 1005073

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Kang, Park, Kwak, Paick, and Kim: Transrectal Needle Biopsy of the Prostate: The Efficacy of a Pre-biopsy Enema
Original Article

Korean J Urol 2008;49(3):248-257.

Published online: 17 January 2008

DOI: https://doi.org/10.4111/kju.2008.49.3.248

Transrectal Needle Biopsy of the Prostate: The Efficacy of a Pre-biopsy Enema

Min Yong Kang, Ju Hyun Park, Cheol Kwak, Jae-Seung Paick, Hyeon Hoe Kim

1Department of Urology, Seoul National University College of Medicine, Seoul, Korea

교신저자: 김현회 서울대학교병원 비뇨기과 서울시 종로구 연건동 28 110-744, TEL: 02-2072-2425, FAX: 02-747-9824, E-mail: hhkim@snu.ac.k

      Revised 7 January 2008       Accepted 11 February 2008

Copyright © 2008 The Korean Urological Association

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

There are numerous biopsy protocols that have been described in the clinical literature. We especially assess the role of the use of an enema before a transrectal prostate biopsy by comparing the post biopsy-infectious complications rate.

Materials and Methods

From January 2007 to August 2007 we retrospectively evaluated 302 men who underwent transrectal needle biopsy of the prostate according to the inclusion criteria. Patients in group 1 (121 patients) did not receive an enema and were given oral ciprofloxacin (500 mg) for 3 days. Those in group 2 (181 patients) received an enema before the biopsy and were also administered intravenous ciprofloxacin (400mg) and an additional oral form (500mg) for five days. Only complications related to infection were evaluated, that is, fever and chills with systemic inflammatory symptoms, within two weeks after the biopsy.

Results

Patients demographics, such as age and prostate size did not differ between the two groups (p＞0.05), but the level of prostate-specific antigen (PSA) in group 2 was significantly higher than in group 1 (12.70ng/ml versus 28.88ng/ml, p＜0.05). The cancer detection rate was 36.1% (109/ 302) overall and there was no significant difference between the two groups (32.2% versus 38.7%, p＞0.05). The infectious complications rate was 2.6% (8/302) overall and did not differ significantly between the two groups (2.5% versus 2.8%, p＞0.05). Especially for group 2 patients, there were two cases of bacteremia and Escherichia coli was reported as the pathogen.

Conclusions

Our findings suggest that the use of a pre-biopsy enema shows no significant benefit given the considerations of infectious complications rate, and the patient quality of life.

Keywords: Prostate, Complications, Infection, Enema

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Table 1.
Patient characteristics
Group 1 Group 2 p-value
No. of patients 121 181
Mean age (years) 64.13±8.15† 67.3±6.5† 0.800∗
Prostate-specific antigen (ng/ml) 12.70 (0.7-191) 28.88 (0.2-1850) 0.026∗
Prostate size (ml) 52.52±23.68† 50.33±30.44† 0.479∗

∗ Student's t-test,

† standard deviation

Table 2.
Post biopsy parameters
Group 1 Group 2 p-value
Prostate cancer (%) 32.3 (39/121) 38.7 (70/181) 0.154∗
Infective complications (%) 2.6 (8/302) 2.8 (5/181) 0.593∗
Prostatitis in pathology (%) 2.5 (3/121) 6.1 (11/181) 0.118∗

∗ chi-square test

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