JCU - January 2022 - 54

984037
URO
Journal of Clinical UrologyRodrigues et al.
Cohort Study
Major post-prostate biopsy
complications under antibiotic
augmentation prophylaxis protocol
Antônio Antunes Rodrigues Jr1,4,6 , Valdair Muglia2,
Emanuel Veras de Albuquerque1, Rafael Ribeiro Mori3,
Rafael Neuppmann Feres1,4, André Beluso Nogueira5,
Vanessa Soares de Oliveira e Almeida6,7,
Guilherme Carvalho Freire6,7, Henrique Amorim Santos6,
Sandra Conceição dos Santos7, Adauto José Cologna1,
Silvio Tucci Jr1 and Rodolfo Borges dos Reis1
Abstract
Objective: To identify risk factors for major post-biopsy complications under augmented prophylaxis protocol. The
risk factors already described mainly comprise outdated antibiotic prophylaxis protocols.
Material and methods: This retrospective cohort study included patients that underwent transrectal ultrasoundguided
biopsies, from 2011 to 2016. All patients had received antibiotic prophylaxis with ciprofloxacin and gentamicin.
Patients were grouped according to the presence or absence of post-biopsy complications. Demographic variables and
possible risk factors based on routine clinical assessment were registered. Correlation tests, univariate and multivariate
analyses were used to identify risk factors for post-biopsy complications.
Results: Of the 404 patients that were included, 25 (6.2%) presented 27 post-biopsy complications, distributed as
follows: acute urinary retention (n = 14, 3.5%), infections (n = 11, 2.7%) and hemorrhage (n = 2, 0.5%). On univariate
analysis, patients who presented complications showed higher body mass index and post-voiding residual volumes.
Multivariate analysis identified ethnicity and prostate-specific antigen (PSA) density as possible risk factors for biopsy
complications. The presence of bacterial resistance identified by rectal swabs did not correlate with the incidence of
complications and infections.
Conclusions: Non-infectious post-biopsy complications were more frequent than infectious ones in this cohort. Higher
post-voiding residual volumes and PSA density, that indicates prostate enlargement, were identified as risk factors and
interpreted as secondary to bladder outlet obstruction. The higher body mass index and ethnicity were also identified
as risk factors and attributed to the heterogeneity of the patients included.
Level of evidence: Not applicable for this multicentre audit.
1 Division of Urology, Ribeirão Preto Medical School, University of São
Paulo, Brazil
2 Division of Radiology, Ribeirão Preto Medical School, University of
São Paulo, Brazil
3 Graduate Studies in Surgery Program, Ribeirão Preto Medical School,
University of São Paulo, Brazil
4 Medical Specialties Outpatient Clinics, Américo Brasiliense State
Hospital, Brazil
5 Infection Control Committee, Américo Brasiliense State Hospital,
Brazil
6Barretos School of Health Sciences, Brazil
7Medical Specialties Outpatient Clinics, Barretos, Brazil
Corresponding author:
Antônio Antunes Rodrigues Jr, Surgery and Anatomy Department,
Ribeirão Preto School of Medicine, São Paulo University, Avenida dos
Bandeirantes 3900, Hospital das Clinicas, 9th floor, Ribeirao Preto,
14048 900, Brazil.
Email: aantunes@hcrp.usp.br
Journal of Clinical Urology
2022, Vol. 15(1) 54 -62
© British Association of
Urological Surgeons 2021
Article reuse guidelines:
sagepub.com/journals-permissions
DOI: 10.1177/2051415820984037
journals.sagepub.com/home/uro
https://doi.org/10.1177/2051415820984037
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