JCU - January 2022 - 60

60
Journal of Clinical Urology 15(1)
Table 5. The relative risk of variables related to all complications and to infections after prostate biopsies.
Variable
RR
Age
BMI
Ethinic group
CCI
Familiar history
Previous biopsy
IPSS
PSA density
Antibiotic resistance
Serum creatinine
Post-voiding residual volume
IPP
Prostatitis
Complications
0.66
0.99
0.68
1.38
0.69
0.99
1.75
4.12*
0.75
0.93
0.40
0.68
1.58
or not prostatitis on these exams, respectively 9/73 (12.3%)
and 42/331 (12.6)%, p = 0.94.
Multivariate analyses. The relative risks of tested variables
following all complications and infections are shown in
Table 5. The PSA density was identified as a risk factor for
major post-biopsy complications, and ethnicity was identified
as a risk factor just for infections complications.
Discussion
Risk factors for post-biopsy complications have already
been described such as age, ethnicity, comorbidity rates,
visits to India and Asia, previous infections of the genitourinary
tract, prostate size and antibiotic resistance of the
rectal microbiota. 6,12,19 These risk factors can be considered
outdated because they were described under diverse
antibiotic prophylaxis schemes, in a scenario where infections
were the most frequent complication.6,9-12,17-20 In this
study, BMI, post-voiding residual volume, ethnic group
and PSA density were associated with major post-biopsy
complications. The post-voiding residual volume and PSA
density are both variables related to the prostate enlargement
and bladder outlet obstruction.4,17,19-21
A low rate of post-biopsy infections (2.7%) and hospitalizations
due to infections (0.7%) was found. The infective
complications remained as our primary cause of post-biopsy
hospitalizations. These results are comparable to the contemporary
series, including those under the target and
empirical prophylaxis protocols.6,9-11,21-23 Since no resistance
to ciprofloxacin/gentamicin neither to ciprofloxacin/
Confidence
limits (95%)
0.31 - 1.32
0.14 - 7.19
0.30 - 1.53
0.20 - 9.75
0.21 - 2.21
0.30 - 3.27
0.23 - 13.2
0.96 - 17.7
0.29 - 1.93
0.40 - 2.17
0.13 - 1.21
0.19 - 2.45
0.47 - 5.25
RR
Infections
0.43
4.93
0.23*
0.58
0.98
0.43
0.78
1.65
1.88
1.04
0.72
1.69
0.69
Confidence
limits (95%)
0.13 - 1.39
0.47 - 51.3
0.07 - 0.78
0.08 - 4.30
0.13 - 7.48
0.12 - 1.62
0.09 - 6.68
0.34 - 8.08
0.25 - 14.45
0.50 - 2.17
0.14 - 3.58
0.16 - 18.3
0.18 - 2.60
ceftriaxone combination has been identified in our cohort,
we believe that is acceptable to extrapolate our findings to
compare our results with those from target prophylaxis.
Hiyama et al (2019) showed that a combination of empirical
and target prophylaxis, guided by pre-biopsy rectal swabs,
could be a good strategy to decrease the number of biopsy
complications.23 A similar rate of post-biopsy infections was
shown in our study. Resistance to antibiotics on fecal microbiota
has not been individualized as a possible risk factor for
post-biopsy complications, differently than reported in the
literature.12,19
In Brazil, the PCa incidence is 66.12/100,000 males;
enough to group this country in the second rank of worldwide
incidence.1,24 Nearly half of the Brazilian population
presents some degree of African ancestry, which influences
PCa epidemiology.25,26 In our opinion, ethnicity and
BMI that showed an influence on rates of post-biopsy
complications in our study just pointed to the heterogeneity
of our cohort. We considered the low number of
patients included a limitation of our study. The heterogeneity
of our cohort was considered a strength because we
report similar complication rates to those from other institutions
worldwide.6,9-12,17-22
Conclusion
BMI, ethnicity, post-voiding residual volume and PSA density
were identified as risk factors for post-biopsy complications
in a scenario of a low rate of infections. The findings
of BMI and ethnicity were attributed to the heterogeneity of
the patients included. The findings of higher post-voiding

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