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Peri-procedural povidone-iodine rectal preparation reduces microorganism counts and infectious complications following ultrasound-guided needle biopsy of the prostate

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Abstract

Purpose

The purpose of the study was to evaluate whether a peri-procedural povidone-iodine rectal preparation (PIRP) prior to transrectal ultrasound-guided prostate needle biopsy (TRUS PNB) can reduce microorganism colony counts and infectious complications.

Methods

Our institutional TRUS PNB database was reviewed to identify infectious post-biopsy complications (defined as fever >38.5 °C with positive culture). The last 570 biopsy patients were divided into those administered only preoperative oral and/or parenteral antibiotics (n = 456; chronologically cohorts A–D) versus men receiving peri-procedural PIRP in conjunction with standard preoperative antibiotics (n = 114; cohort E). Rectal cultures were obtained in the PIRP cohort to quantify changes in microorganism colony counts.

Results

Mean baseline PSA for patients was 11.6 ng/ml, 63 % were undergoing an initial biopsy, and 17 % had documented use of antibiotic therapy within the previous 6 months. A reduction in infectious complications was observed when comparing the conventional antibiotic (cohorts A–D) versus PIRP (cohort E) group (1.8 vs. 0 %), with the largest magnitude of decline occurring in the concurrent contemporary cohorts (cohort D—5.3 % vs. cohort E—0 %, p = 0.03). Rectal cultures obtained in 92 men before and after PIRP administration noted a 97 % reduction in microorganism colonies (2.1 × 105 vs. 6.3 × 103 CFU/ml, p < 0.001). No adverse reactions to the PIRP were reported by patients 7 days post-biopsy.

Conclusions

Peri-procedural PIRP decreased microorganism colony counts and effectively reduced infectious complications following TRUS PNB. This safe, cheap, and simple strategy may be a reasonable alternative to systemic or targeted antibiotic therapy to reduce post-biopsy infections.

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Conflict of interest

The authors have no conflict of interest with any material presented in this manuscript.

Ethical standards

This retrospective patient-related study has been approved by our institutional review board (IRB) for research (IRB# 41752EP). There is no patient identifying information included in this manuscript. Patient consent was not obtained as this is a retrospective review of data.

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Authors and Affiliations

  1. Division of Urology, Penn State Milton S. Hershey Medical Center, 500 University Drive, H055, Hershey, PA, 17033-0850, USA

    Justin R. Gyorfi, Christopher Otteni, Kevin Brown, Amar Patel, Kathleen Lehman & Jay D. Raman

  2. Department of Surgery, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA

    Brett E. Phillips

  3. Department of Veterinary and Biomedical Science, Penn State University, University Park, PA, USA

    Kalyan Dewan & Girish Kirimanjeswara

Authors
  1. Justin R. Gyorfi
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  2. Christopher Otteni
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  3. Kevin Brown
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  4. Amar Patel
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  5. Kathleen Lehman
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  6. Brett E. Phillips
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  7. Kalyan Dewan
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  8. Girish Kirimanjeswara
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  9. Jay D. Raman
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Corresponding author

Correspondence to Jay D. Raman.

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Gyorfi, J.R., Otteni, C., Brown, K. et al. Peri-procedural povidone-iodine rectal preparation reduces microorganism counts and infectious complications following ultrasound-guided needle biopsy of the prostate. World J Urol 32, 905–909 (2014). https://doi.org/10.1007/s00345-014-1291-8

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  • DOI: https://doi.org/10.1007/s00345-014-1291-8

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