단일 술자에 의해 외래에서 시행된 경직장초음파하 전립선침생검 후 Betadine 거즈 압박이 입원을 요하는 합병증의 발생에 미치는 영향
Can Betadine Gauze Compression Be Decreased Significant Complications after Prostate Needle Biopsy under Transrectal Ultrasound at Outpatient Department?: Single Clinician’s Experience
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Purpose: Recently, the number of patients undergoing prostate biopsy has increased due to the development of cancer screening test with prostate specific antigen. Prostate needle biopsy under transrectal ultrasound (Bx-TRUS) is the standard procedure to diagnose prostate cancer. We evaluated the incidence of significant infectious and bleeding complications performed by a single urologist with unique methods of betadine gauze compression after Bx-TRUS. Materials and Methods: We retrospectively evaluated the medical records of 299 patients, who underwent Bx-TRUS, from March 2007 to December 2011. All patients received oral levofloxacin 500mg for 4days. Significant complications, related to infection with fever and persistent rectal bleeding, were evaluated within 4 weeks after biopsy. Patients who presented infectious complications were treated with intravenous ceftriaxone 2.0gm for 5 or 7 days. Patients who present significant anal bleeding were managed with primary closure by colorectal clinic in the department of surgery. Results: Among 299 patients, 4patients (1.3%) developed post-biopsy infections and hemorrhage. Those major complications were catergorized as acute prostatitis (2 patients, 0.7%) and rectal bleeding (2 patients,0.7%). Of the 2 cases with post-biopsy infection, 1 case (Escherichia coli) had positive urine and blood culture. E. coli was sensitive to cephalosporine, but was resistant to fluoroquinolone. Conclusions: The results of this study suggest that betadine compression after Bx-TRUS may play the role of decreasing or preventing the significant complications, such as febrile infections and persistent rectal bleeding. Further, well designed study is needed to evaluate the clinical implication of betadine gauze compression after Bx-TRUS.
Abstract
Purpose: Recently, the number of patients undergoing prostate biopsy has increased due to the development of cancer screening test with prostate specific antigen. Prostate needle biopsy under transrectal ultrasound (Bx-TRUS) is the standard procedure to diagnose prostate cancer. We evaluated the incidence of significant infectious and bleeding complications performed by a single urologist with unique methods of betadine gauze compression after Bx-TRUS. Materials and Methods: We retrospectively evaluated the medical records of 299 patients, who underwent Bx-TRUS, from March 2007 to December 2011. All patients received oral levofloxacin 500mg for 4days. Significant complications, related to infection with fever and persistent rectal bleeding, were evaluated within 4 weeks after biopsy. Patients who presented infectious complications were treated with intravenous ceftriaxone 2.0gm for 5 or 7 days. Patients who present significant anal bleeding were managed with primary closure by colorectal clinic in the department of surgery. Results: Among 299 patients, 4patients (1.3%) developed post-biopsy infections and hemorrhage. Those major complications were catergorized as acute prostatitis (2 patients, 0.7%) and rectal bleeding (2 patients,0.7%). Of the 2 cases with post-biopsy infection, 1 case (Escherichia coli) had positive urine and blood culture. E. coli was sensitive to cephalosporine, but was resistant to fluoroquinolone. Conclusions: The results of this study suggest that betadine compression after Bx-TRUS may play the role of decreasing or preventing the significant complications, such as febrile infections and persistent rectal bleeding. Further, well designed study is needed to evaluate the clinical implication of betadine gauze compression after Bx-TRUS.
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