Yıl: 2020 Cilt: 46 Sayı: 2 Sayfa Aralığı: 159 - 164 Metin Dili: İngilizce DOI: 10.5152/tud.2019.19172 İndeks Tarihi: 04-11-2020

Effect of rectal mucosa cleansing on acute prostatitis during prostate biopsy: A randomized prospective study

Öz:
Objective: Infectious complications after transrectal ultrasound-guided prostate biopsy (TRUS-PB) can range from asymptomatic bacteriuria and febrile or non-febrile urinary tract infection (UTI) to sepsis. Cleaning of rectal mucosa with topical antiseptics such as povidone iodine or chlorhexidine before the pro-cedure are alternative prophylaxis methods. We aimed to investigate the effects of these two different topical antiseptic agents on infectious complications and their superiority to each other.Material and methods: The study was conducted with 200 patients. Rectal mucosa cleansings were per-formed in 50 patients with povidone iodine and 49 patients with chlorhexidine. The remaining 101 patients did not receive any antiseptic treatment. The results were examined according to the hospital admissions or hospitalization for the first 30 days after the procedure due to UTI, body temperature >38.5°C, sepsis, hematuria, rectal bleeding, and urinary retention.Results: The mean age of study population was 63.3±7.26 years, and the mean prostate specific antigen value was 13.96±29.5 ng/mL. Acute prostatitis occurred in 14 patients (7%), 9 of whom were hospitalized due to sepsis after TRUS-PB. Statistically significant less acute prostatitis was observed in those patients who were treated with topical rectal antisepsis (topical rectal antisepsis 2% vs. no rectal antisepsis 12.1%, p=0.01). Chlorhexidine and povidone iodine were not superior to each other in terms of inhibiting the devel-opment of acute prostatitis (chlorhexidine 2% vs. povidone iodine 2%, p=1.00).Conclusion: Rectal mucosal cleansing with chlorhexidine or povidone iodine before TRUS-PB prevented the development of sepsis due to acute prostatitis. We recommend that this effective method, which is easy to apply, cheap, reliable, easily tolerated should be used in all prostate biopsy practice.
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Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. American Cancer Society. Cancer facts & figures. American Can-cer Society, Atlanta. 2013.
  • 2. Djavan B, Waldert M, Zlotta A, Dobronski P, Seitz C, Remzi M, et al. Safety and morbidity of first and repeat transrectal ultrasound-guided prostate needle biopsies: results of a prospective European prostate cancer detection study. J Urol 2001;166:856-60. [CrossRef]
  • 3. Loeb S, Carter HB, Berndt SI, Ricker W, Schaeffer EM. Compli-cations after prostate biopsy: data from SEER-Medicare. J Urol 2011;186:1830-4. [CrossRef]
  • 4. UK Department of Health, National schedule of reference costs: the main schedule. Available from: https://www.gov.uk/govern-ment/publications/ nhs-reference-costs-2014-to-2015.
  • 5. Liss MA, Ehdaie B, Loeb S, Meng MV, Raman JD, Spears V, et al. An update of the American Urological Association white paper on the prevention and treatment of the more common complications related to prostate biopsy. J Urol 2017;198:329-34. [CrossRef]
  • 6. Mosharafa AA, Torky MH, El Said WM, Meshref A. Rising inci-dence of acute prostatitis following prostate biopsy: fluoroquino-lone resistance and exposure is a significant risk factor. Urology 2011;78:511-4. [CrossRef]
  • 7. Zowawi HM, Harris PN, Roberts MJ, Tambyah PA, Schembri MA, Pezzani MD, et al. The emerging threat of multidrug resistant gram negative bacteria in urology. Nat Rev Urol 2015;12:570-84. [CrossRef]
  • 8. Park R, Gyorfı J, Dewan K, Kirimanjeswara G, Clark JY, Kaag MG, et al. Topical rectal antiseptic at time of prostate biopsy: how a resident patient safety project has evolved into institutional prac-tice. Int Urol Nephrol 2018;50:1563-8. [CrossRef]
  • 9. Bennett HY, Roberts MJ, Doi SA, Gardiner RA. The global burden of major infectious complications following prostate biopsy. Epi-demiol Infect 2016;144:1784-91. [CrossRef]
  • 10. Urbanek K, Kolar M, Strojil J, Koukalová D, Cekanová L, Hejnar P. Utilization of fluoroquinolones and Escherichia coli resistance in urinary tract infection: inpatients and outpatients. Pharmacoepi-demiol Drug Saf 2005;14:741-5. [CrossRef]
  • 11. Lu DD, Raman DJ. Strategies for prevention of ultrasound guid-ed prostate biopsy infections. Infect Drug Resist 2016;8:161-9. [CrossRef]
  • 12. Chamberland RR. Cutting to the core of the issue: emerging strate-gies to reduce prostate biopsy related infections. J Clin Microbiol 2016;54:2431-5. [CrossRef]
  • 13. Toner L, Bolton MD, Lawrentschuk N. Prevention of sep-sis prior to prostate biopsy. Investig Clin Urol 2016;57:94-9. [CrossRef]
  • 14. Kanjanawongdeengam P, Viseshsindh W, Santanirand P, Prathom-butr P, Nilkulwattana S. Reduction in bacteremia rates after rectum sterilization before transrectal ultrasound guided prostate biopsy: a randomized controlled trial. J Med Assoc Thai 2009;92:1621-6.
  • 15. Ghafoori M, Shakiba M, Seifmanesh H, Hoseini K. Decrease in infection rate following use of povidone iodine during transrectal, ultrasound-guided biopsy of the prostate: a double-blind random-ized clinical trial. Iran J Radiol 2012;9:67-70. [CrossRef]
  • 16. Tsai JC, Lin YK, Huang YJ, Loh EW, Wen HY, Wang CH, et al. Antiseptic effect of conventional povidone iodine scrub, chlorhex-idine scrub, and waterless hand rub in a surgical room: a random-ized controlled trial. Infect Control Hosp Epidemiol 2017;38:417-22. [CrossRef]
  • 17. Carey JM, Korman HJ. Transrectal ultrasound guided biopsy of the prostate. Do enemas decrease clinically significant complica-tions? J Urol 2001;166:82-5. [CrossRef]
  • 18. Park DS, Oh JJ, Lee JH, Jang WK, Hong YK, Hong SK. Simple use of the suppository type povidone-iodine can prevent infectious complications in transrectal ultrasound-guided prostate biopsy. Adv Urol 2009:750598. [CrossRef]
APA ERGANİ B, ÇETİN T, Yalçın M, Özbilen M, BİLDİRİCİ Ç, Karaca E, Koc G, ilbey y, BOYACIOĞLU H (2020). Effect of rectal mucosa cleansing on acute prostatitis during prostate biopsy: A randomized prospective study. , 159 - 164. 10.5152/tud.2019.19172
Chicago ERGANİ BATUHAN,ÇETİN Taha,Yalçın Mehmet Yiğit,Özbilen Mert Hamza,BİLDİRİCİ ÇAĞDAŞ,Karaca Erkin,Koc Gokhan,ilbey yusuf özlem,BOYACIOĞLU Hayal Effect of rectal mucosa cleansing on acute prostatitis during prostate biopsy: A randomized prospective study. (2020): 159 - 164. 10.5152/tud.2019.19172
MLA ERGANİ BATUHAN,ÇETİN Taha,Yalçın Mehmet Yiğit,Özbilen Mert Hamza,BİLDİRİCİ ÇAĞDAŞ,Karaca Erkin,Koc Gokhan,ilbey yusuf özlem,BOYACIOĞLU Hayal Effect of rectal mucosa cleansing on acute prostatitis during prostate biopsy: A randomized prospective study. , 2020, ss.159 - 164. 10.5152/tud.2019.19172
AMA ERGANİ B,ÇETİN T,Yalçın M,Özbilen M,BİLDİRİCİ Ç,Karaca E,Koc G,ilbey y,BOYACIOĞLU H Effect of rectal mucosa cleansing on acute prostatitis during prostate biopsy: A randomized prospective study. . 2020; 159 - 164. 10.5152/tud.2019.19172
Vancouver ERGANİ B,ÇETİN T,Yalçın M,Özbilen M,BİLDİRİCİ Ç,Karaca E,Koc G,ilbey y,BOYACIOĞLU H Effect of rectal mucosa cleansing on acute prostatitis during prostate biopsy: A randomized prospective study. . 2020; 159 - 164. 10.5152/tud.2019.19172
IEEE ERGANİ B,ÇETİN T,Yalçın M,Özbilen M,BİLDİRİCİ Ç,Karaca E,Koc G,ilbey y,BOYACIOĞLU H "Effect of rectal mucosa cleansing on acute prostatitis during prostate biopsy: A randomized prospective study." , ss.159 - 164, 2020. 10.5152/tud.2019.19172
ISNAD ERGANİ, BATUHAN vd. "Effect of rectal mucosa cleansing on acute prostatitis during prostate biopsy: A randomized prospective study". (2020), 159-164. https://doi.org/10.5152/tud.2019.19172
APA ERGANİ B, ÇETİN T, Yalçın M, Özbilen M, BİLDİRİCİ Ç, Karaca E, Koc G, ilbey y, BOYACIOĞLU H (2020). Effect of rectal mucosa cleansing on acute prostatitis during prostate biopsy: A randomized prospective study. Turkish Journal of Urology, 46(2), 159 - 164. 10.5152/tud.2019.19172
Chicago ERGANİ BATUHAN,ÇETİN Taha,Yalçın Mehmet Yiğit,Özbilen Mert Hamza,BİLDİRİCİ ÇAĞDAŞ,Karaca Erkin,Koc Gokhan,ilbey yusuf özlem,BOYACIOĞLU Hayal Effect of rectal mucosa cleansing on acute prostatitis during prostate biopsy: A randomized prospective study. Turkish Journal of Urology 46, no.2 (2020): 159 - 164. 10.5152/tud.2019.19172
MLA ERGANİ BATUHAN,ÇETİN Taha,Yalçın Mehmet Yiğit,Özbilen Mert Hamza,BİLDİRİCİ ÇAĞDAŞ,Karaca Erkin,Koc Gokhan,ilbey yusuf özlem,BOYACIOĞLU Hayal Effect of rectal mucosa cleansing on acute prostatitis during prostate biopsy: A randomized prospective study. Turkish Journal of Urology, vol.46, no.2, 2020, ss.159 - 164. 10.5152/tud.2019.19172
AMA ERGANİ B,ÇETİN T,Yalçın M,Özbilen M,BİLDİRİCİ Ç,Karaca E,Koc G,ilbey y,BOYACIOĞLU H Effect of rectal mucosa cleansing on acute prostatitis during prostate biopsy: A randomized prospective study. Turkish Journal of Urology. 2020; 46(2): 159 - 164. 10.5152/tud.2019.19172
Vancouver ERGANİ B,ÇETİN T,Yalçın M,Özbilen M,BİLDİRİCİ Ç,Karaca E,Koc G,ilbey y,BOYACIOĞLU H Effect of rectal mucosa cleansing on acute prostatitis during prostate biopsy: A randomized prospective study. Turkish Journal of Urology. 2020; 46(2): 159 - 164. 10.5152/tud.2019.19172
IEEE ERGANİ B,ÇETİN T,Yalçın M,Özbilen M,BİLDİRİCİ Ç,Karaca E,Koc G,ilbey y,BOYACIOĞLU H "Effect of rectal mucosa cleansing on acute prostatitis during prostate biopsy: A randomized prospective study." Turkish Journal of Urology, 46, ss.159 - 164, 2020. 10.5152/tud.2019.19172
ISNAD ERGANİ, BATUHAN vd. "Effect of rectal mucosa cleansing on acute prostatitis during prostate biopsy: A randomized prospective study". Turkish Journal of Urology 46/2 (2020), 159-164. https://doi.org/10.5152/tud.2019.19172