Complications of transrectal prostate biopsy

Aim: to determine transrectal prostate biopsy (TPB) complications, their frequency and correlation with various risk factors. Objectives: 1. To determine the most common complications of TPB. 2. To evaluate the correlation of these complications and various clinical characteristics. 3. To evaluate the distribution of these complications in different age groups. Methods: the parameters of the transrectal ultrasound examination (TUE) and the data of the questionnaire survey (including age and the presence of the most common TPB complications (hematuria, rectal bleeding, hematospermia, pain, lower urinary tract symptoms (LUTS), infections, acute urinary retention)) were analysed. The correlation between TPB complications and the factors that may increase their frequency (age, weight, diabetes mellitus (DM), the history of stroke or myocardial infarction (MI), the number of biopsy samples, TUE parameters, and repeated biopsy) were determined. A p value of < 0.05 was considered statistically significant. Subjects: 208 patients who underwent TPB at the Hospital of Lithuanian University of Health Sciences Kaunas Clinics. Results: the frequency of the complications after TPB was: hematuria 46,15%, perineal pain 37,98%, hematospermia 34,13%, rectal bleeding 17,3%, dysuria 8,65%, fever 8,65%, urinary retention 3,37%, urosepsis 2,4 proc. The higher number of biopsy samples increased the frequency of hematospermia (p = 0,012) and fever (p = 0,049). The total number of complications was higher for younger patients (p = 0,001), they reported about hematospermia (p < 0,001), fever (p = 0,003) and urosepsis (p < 0,001) more often. In the age group 60-69y., patients had a higher incidence of hematospermia (p < 0,001); sepsis was more common in the age group < 60y. (p = 0,002). Patients with a history of MI felt perineal pain (p = 0,041) less often; those who had had stroke more often complained about urinary retention (p = 0,008). Patients with higher prostate volume (PV) had rectal bleeding (p = 0,034) and hematuria (p = 0,047) less often, but more often complained about urinary retention (p = 0,003); patients with lower transitory zone (TZ) less often had hematuria (p = 0,049). Conclusions: 1. The most common complications after TPB were hematuria, perineal pain, hematospermia; the least common were urinary retention and urosepsis. 2. The frequency of complications correlated with the number of biopsy samples, PV, TZ, history of MI and stroke, but had no correlation with repeated biopsy, DM, overweight and obesity. 3. Hematospermia was more common in the age group 60-69 and urosepsis – in the age group < 60