Factors affecting accuracy and morbidity in transrectal biopsy of the prostate
Bissada, N.K.; Rountree, G.A.; Sulieman, J.S.
Surgery Gynecology and Obstetrics 145(6): 869-872
1977
ISSN/ISBN: 0039-6087 PMID: 303813 Document Number: 117230
The findings in 306 patients who underwent transrectal needle biopsy of the prostate were analyzed. An increased incidence of positive biopsies for carcinoma occurred at the age of 60 yr. The overall incidence of a positive biopsy was 49%, while patients with highly suspicious clinical evidence of carcinoma had a 75% incidence of positive biopsy. Transrectal biopsy of the prostate was accurate in 81.3% on single biopsy and 90.4% with multiple biopsies. Repeated biopsies are justified in patients with an initial negative biopsy who have strong clinical evidence of carcinoma of the prostate. One hundred and fifty-eight complications occurred in 121 patients. Infection occurred in 35% of the patients. Pretreatment with antimicrobial agents resulted in a significant reduction in the incidence of infection. Retention of urine and gross hematuria developed in 11 and 27% of the patients, respectively. There was no difference in the incidence of retention of urine whether the biopsy was performed alone or combined with instrumentation. The incidence of gross hematuria was significantly increased when biopsy and instrumentation were performed together. Severe rectal bleeding developed in 2.3% of the patients. There was no difference in the incidence of this complication whether the prostate was benign or malignant.