February 16th, 2018
Transrectal ultrasound-guided prostate biopsy is usually an uncomplicated procedure, often performed in an office setting with only local anesthesia. Antibiotics are used as prophylaxis before the procedure, further reducing the rate of complications like urosepsis and prostatitis. So what can be the Complications of Prostate Biopsy?
Urinary tract infection is the most common infectious complication, and although it is greatly reduced by prophylactic antibiotics, the risk is not eliminated. The risk of serious infection, including sepsis, is increased with factors that include presence of an indwelling urinary catheter, recent hospitalization, COPD or diabetes mellitus.
Most individuals will have some minor bleeding in the urine or from the rectum, but it resolves quickly after the procedure. No treatment is usually required. If a large number of biopsy samples are obtained, the risk of rectal bleeding increases. Rarely, brisk rectal bleeding will require manual compression of the prostate or rectal packing with gauze. If bleeding won’t stop with these measures, the urologist may consider an endoscopic epinephrine injection or clip or surgical ligation.
You may also develop obstruction of the urinary tract due to swelling after the biopsy. If you have symptoms of urinary retention, including discomfort and feeling of incomplete voiding, the nurse can check your post-void residual volume and you may be treated with medication or a small catheter.
Post-biopsy prostatitis is a rare but serious inflammatory complication. Finally, there is a minimal risk that tumor cells may spread through the needle tract, but that has only been reported in isolated cases, usually associated with transperineal biopsy.
Transperineal biopsy is associated with a higher rate of complications, including blood in the urine, blood in sperm, and urinary tract infection. This type of biopsy is generally used for special circumstances, using ultrasound, CT, or MRI guidance to obtain biopsy samples.
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