JCU - January 2022 - 56

56
Journal of Clinical Urology 15(1)
procedure. Under ultrasound orientation, a total volume of
15 ml of 1% Lidocaine solution was injected through an
18-gauge needle in prostate apices and base and, subsequently,
inside the prostate. All patients were asked about
the intensity of pain immediately after the procedure based
on the Visual Analog Scale (VAS), graded from '0' to '10'.
Post-biopsy active tracking of complications. Patients were
monitored by daily phone calls in the first week and weekly
phone calls over the next three weeks. Patients with possible
complications identified by phone calls had their
clinical evaluations anticipated, and infections were presumed
when patients presented with fever (body temperature
⩾ 38oC) or urinary urgency, frequency, dysuria,
suprapubic tenderness, chills and malaise, pyuria (even
without fever), or signs of urosepsis. Patients with signs of
urosepsis were hospitalized to initiate antibiotic therapy
based on previous rectal swab cultures.
Analysis of biopsy complication rates and
possible risk factors
Complication rates of biopsy. The frequency of infectious
complications, acute urinary retention and bleeding
(grouping gross hematuria and rectal bleeding) after the
biopsy were annotated and assumed as major complications,
following the previously described classification,17
were reported. Minor complications, such as vasovagal
syncope, mild hematuria and hematospermia or transient
rectal bleeding were not described.
Descriptive analysis of the antibiotic resistance of rectal microbiota.
The prevalence of antibiotic resistance on rectal
microbiota was described for both groups; the rates of the
three most frequent micro-organism isolated in rectal swab
cultures were presented as percentages; all antibiotic
resistances were also described as percentages.
Statistical analysis
A Shapiro-Wilk's test and a visual inspection of their histograms
were performed to verify if the variables were
normally distributed. Continuous variables were compared
between two institutions, and between Groups 1 and 2,
through non-paired Student`s t-test with previous Levine's
test, presented as mean values ± standard deviation.
Different variable frequencies were evaluated through
Pearson chi-square and Fisher's exact tests; relevant percentages
were described. Chi-square was performed to test
exposure
factors
against
outcomes.
Spearman
Rho
Correlation Coefficients were used to correlate complications
and possible risk factors. The multivariate analyses
used log-binomial to estimate the relative risk of tested
variables related to all complications and to infection.18
The SPSS and SAS 9.2 software were used for statistical
analyses (IBM Corp. Released 2013. IBM SPSS Statistics
for Macintosh, Version 22.0. Armonk, NY: IBM Corp.; the
SAS system for Windows. Release 9.2. SAS Inst., Cary,
NC. 2011). Significance was set as 5%.
Results
Patient characteristics
Demographic data. We reviewed the prostate biopsy findings
from 404 patients of two public institutions in Brazil,
AMEs of Americo Brasiliense (n = 302) and Barretos (n
= 102). All patients had negative urine culture samples
before biopsies; those with indwelling catheter had the
procedure performed during treatment with antibiotics.
Population characteristics from the two institutions were
not different. The mean values for age were 65.6 ± 8.3
years; life expectancy, 16.2 ± 5.3 years; body mass index
(BMI), 26.3 ± 4.8 kg/m2.The ethnic distribution of the
entire sample was presented as follows: 72.3% (292) were
Caucasian (white); 14.1% (57) were Mulattos (browns);
9.3% (36) were African American (black), and 0.8% (4)
from other origins. We found a difference between ethnic
distribution from two institutions (AME-Americo/AME-
Barretos): Caucasians (292/75); Mulattos (57/6); African
American (36/20); others (4/1), p < 0.0001; however, no
difference in the rate of major post-biopsy complications
were noted between these ethnic groups, p = 0.76. A
familiar history of PCa was present in 36 (8.9%) patients,
and 47 (11.6%) had undergone at least one previous
biopsy.
Lower urinary tract dysfunctions data. Digital rectal examination
(DRE) prostate volume, 47.5 ± 20.0 cm3; ultrasound
prostatic volume, 50.2 ± 30.6 cm3; transitional-zone
prostatic volume, 31.7 ± 25.4 cm3; PSA, 11.2 ± 23.4 ng/
ml, PSA density, 0.27 ± 0.66 ng/ml.cm3; transitional-zone
prostatic density, 0.44 ± 0.77 ng/ml.cm3; fPSA/tPSA ratio,
0.15 ± 0.08; intraprostatic profusion, 9.62 ± 2.58 mm;
post-voiding residual volume, 60.3 ± 71.2 ml. Before
biopsies, 337 (83.4%) patients presented mild IPSS, 39
(9.7%) moderate, 21 (5.2%) severe and 7 (1.7%) were
using indwelling catheters.
Comorbidity profile. Of the 404 patients 209 (51.7%) presented
no-comorbidities while 195 (48.3%) had at least
one comorbidity, such as diabetes mellitus 102 (25.2%),
hypertension 200 (49.5%), cardiovascular disease 67
(26.6%) and chronic kidney disease 29 (7.6%). The mean
value of serum creatinine was 1.07 ± 0.7 mg/ml for the
entire cohort. Seventy-five (18.6%) and 22 (5.4%) patients,
respectively, presented age-unadjusted CCI scores ⩾ 2 and
⩾ 3; 23 (5.7%) patients presented age-adjusted CCI ⩾ 6.

JCU - January 2022

Table of Contents for the Digital Edition of JCU - January 2022

Contents
JCU - January 2022 - Cover1
JCU - January 2022 - Contents
JCU - January 2022 - 2
JCU - January 2022 - 3
JCU - January 2022 - 4
JCU - January 2022 - 5
JCU - January 2022 - 6
JCU - January 2022 - 7
JCU - January 2022 - 8
JCU - January 2022 - 9
JCU - January 2022 - 10
JCU - January 2022 - 11
JCU - January 2022 - 12
JCU - January 2022 - 13
JCU - January 2022 - 14
JCU - January 2022 - 15
JCU - January 2022 - 16
JCU - January 2022 - 17
JCU - January 2022 - 18
JCU - January 2022 - 19
JCU - January 2022 - 20
JCU - January 2022 - 21
JCU - January 2022 - 22
JCU - January 2022 - 23
JCU - January 2022 - 24
JCU - January 2022 - 25
JCU - January 2022 - 26
JCU - January 2022 - 27
JCU - January 2022 - 28
JCU - January 2022 - 29
JCU - January 2022 - 30
JCU - January 2022 - 31
JCU - January 2022 - 32
JCU - January 2022 - 33
JCU - January 2022 - 34
JCU - January 2022 - 35
JCU - January 2022 - 36
JCU - January 2022 - 37
JCU - January 2022 - 38
JCU - January 2022 - 39
JCU - January 2022 - 40
JCU - January 2022 - 41
JCU - January 2022 - 42
JCU - January 2022 - 43
JCU - January 2022 - 44
JCU - January 2022 - 45
JCU - January 2022 - 46
JCU - January 2022 - 47
JCU - January 2022 - 48
JCU - January 2022 - 49
JCU - January 2022 - 50
JCU - January 2022 - 51
JCU - January 2022 - 52
JCU - January 2022 - 53
JCU - January 2022 - 54
JCU - January 2022 - 55
JCU - January 2022 - 56
JCU - January 2022 - 57
JCU - January 2022 - 58
JCU - January 2022 - 59
JCU - January 2022 - 60
JCU - January 2022 - 61
JCU - January 2022 - 62
JCU - January 2022 - 63
JCU - January 2022 - 64
JCU - January 2022 - 65
JCU - January 2022 - 66
JCU - January 2022 - 67
JCU - January 2022 - 68
JCU - January 2022 - 69
JCU - January 2022 - 70
JCU - January 2022 - 71
JCU - January 2022 - 72
JCU - January 2022 - 73
JCU - January 2022 - 74
JCU - January 2022 - 75
JCU - January 2022 - 76
JCU - January 2022 - 77
JCU - January 2022 - 78
JCU - January 2022 - Cover3
JCU - January 2022 - Cover4
https://www.nxtbookmedia.com