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Does metabolic syndrome increase the risk of infective complications after prostate biopsy? A critical evaluation

  • Urology - Original Paper
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Abstract

Purpose

To evaluate the possible association between metabolic syndrome (MetS) and infectious complications after prostate biopsy.

Methods

A total of 480 men underwent prostatic biopsy due to elevated prostate-specific antigen levels and/or abnormal digital rectal examination. Patients were divided into two subgroups with respect to the presence or absence of MetS. Patients in both groups were closely followed with respect to infectious complications after biopsy and the possible effect of MetS as a certain risk factor on these complications was evaluated with a multivariate analysis.

Results

Infectious complications were observed in 33 cases (6.8 %), while urinary tract infection (UTI) was detected in 30 (6.2 %) cases, sepsis occurred in three (0.6 %) cases. The percentage of the cases with infectious complications was 11.0 and 3.4 % in men with and without MetS, respectively (p = 0.002). These rates were 3.7 versus 1.5 %, respectively, for UTI (p < 0.003) and 0.9 versus 0.4 %, respectively, for sepsis in both groups (p = 0.594). Multivariate analysis of the data confirmed that MetS was associated with an increased risk of infective complications (odds ratio 3.44 and 95 % CI 1.56–7.58, p < 0.002) after this procedure.

Conclusions

MetS could pose a certain increased risk for infectious complications after prostate biopsy. Patients with MetS should be considered as risk cases for this procedure, and they should be evaluated and followed in a very close manner with respect to these complications.

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References

  1. Liss MA, Chang A, Santos R, Nakama-Peeples A, Peterson EM, Osann K et al (2011) Prevalence and significance of fluoroquinolone resistant Escherichia coli in patients undergoing transrectal ultrasound guided prostate needle biopsy. J Urol 185:1283–1288

    Article  PubMed Central  PubMed  Google Scholar 

  2. Loeb S, Vellekoop A, Ahmed HU, Catto J, Emberton M, Nam R, Rosario DJ, Scattoni V, Lotan Y (2013) Systematic review of complications of prostate biopsy. Eur Urol 64(6):876–892

    Article  PubMed  Google Scholar 

  3. Rodrı´guez LV, Terris MK (1998) Risks and complications of transrectal ultrasound guided prostate needle biopsy: a prospective study and review of the literature. J Urol 160:2115–2120

    Article  Google Scholar 

  4. Tal R, Livne PM, Lask DM, Baniel J (2003) Empirical management of urinary tract infections complicating transrectal ultrasound guided prostate biopsy. J Urol 169(5):1762–1765

    Article  PubMed  Google Scholar 

  5. Nam RK, Saskin R, Lee Y, Liu Y, Law C, Klotz LH et al (2010) Increasing hospital admission rates for urological complications after transrectal ultrasound guided prostate biopsy. J Urol 183:963–968

    Article  PubMed  Google Scholar 

  6. Pinkhasov GI, Lin YK, Palmerola R, Smith P, Mahon F, Kaag MG et al (2012) Complications following prostate needle biopsy requiring hospital admission or emergency department visits—experience from 1,000 consecutive cases. BJU Int 110:369–374

    Article  PubMed  Google Scholar 

  7. Feliciano J, Teper E, Ferrandino M, Macchia RJ, Blank W, Grunberger I et al (2008) The incidence of fluoroquinolone resistant infections after prostate biopsy—are fluoroquinolones still effective prophylaxis? J Urol 179:952–955

    Article  PubMed  Google Scholar 

  8. Simsir A, Kismali E, Mammadov R, Gunaydin G, Cal C (2010) Is it possible to predict sepsis, the most serious complication in prostate biopsy? Urol Int 84:395–399

    Article  PubMed  Google Scholar 

  9. Loeb S, van den Heuvel S, Zhu X, Bangma CH, Schröder FH, Roobol MJ (2012) Infectious complications and hospital admissions after prostate biopsy in a European randomized trial. Eur Urol 61:1110–1114

    Article  PubMed  Google Scholar 

  10. Mosharafa AA, Torky MH, El Said WM, Meshref A (2011) Rising incidence of acute prostatitis following prostate biopsy: fluoroquinolone resistance and exposure is a significant risk factor. Urology 78:511–515

    Article  PubMed  Google Scholar 

  11. Ford ES, Giles WH, Dietz WH (2002) Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey. JAMA 287:356–359

    Article  PubMed  Google Scholar 

  12. Kirby MG, Wagg A, Cardozo L, Chapple C, Castro-Diaz D, de Ridder D et al (2010) Overactive bladder: Is there a link to the metabolic syndrome in men? Neurourol Urodyn 29:1360–1364

    Article  PubMed  Google Scholar 

  13. Vignozzi L, Morelli A, Sarchielli E, Comeglio P, Filippi S, Cellai I et al (2012) Testosterone protects from metabolic syndrome-associated prostate inflammation: an experimental study in rabbit. J Endocrinol 212:71–84

    Article  CAS  PubMed  Google Scholar 

  14. Coppieters KT, von Herrath MG (2014) Metabolicsyndrome—removing road blocks to therapy: antigenic immunotherapies. Mol Metab 3:275–283

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  15. Cosimo De Nunzio (2012) The correlation between metabolic syndrome and prostatic diseases. Eur Urol 61:560–570

    Article  PubMed  Google Scholar 

  16. Park YW, Kim SB, Kwon H, Kang HC, Cho K, Lee KI et al (2013) The relationship between lower urinary tract symptoms/benign prostatic hyperplasia and the number of components of metabolic syndrome. Urology 82:674–679

    Article  PubMed  Google Scholar 

  17. Kupelian V, Shabsigh R, Araujo AB, O’Donnell AB, McKinlay JB (2006) Erectile dysfunction as a predictor of the metabolic syndrome in aging men: results from the Massachusetts Male Aging Study. J Urol 176:222–226

    Article  PubMed  Google Scholar 

  18. Singh AK, Kari JA (2013) Metabolic syndrome and chronic kidney disease. Curr Opin Nephrol Hypertens 22:198–203

    Article  CAS  PubMed  Google Scholar 

  19. American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference (1992) Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Crit Care Med 20:864–874

    Article  Google Scholar 

  20. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (2001) Executive summary of the third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (ATP III). JAMA 285:2486–2497

    Article  Google Scholar 

  21. Falagas ME, Kastoris AC, Kapaskelis AM, Karageorgopoulos DE (2010) Fosfomycin for the treatment of multidrug-resistant, including extended-spectrum beta-lactamase producing, Enterobacteriaceae infections: a systematic review. Lancet Infect Dis 10:43–50

    Article  CAS  PubMed  Google Scholar 

  22. Gupta V (2010) Metabolic syndrome what are the risks for humans? Biosci Trends 4:204–212

    PubMed  Google Scholar 

  23. Geerlings SE, Brouwer EC, Gaastra W, Verhoef J, Hoepelman AI (1999) Effect of glucose and pH on uropathogenic and non-uropathogenic Escherichia coli: studies with urine from diabetic and non-diabetic individuals. J Med Microbiol 48:535–539

    Article  CAS  PubMed  Google Scholar 

  24. Selph JP, Whited WM, Smith AB, Matthews J, Pruthi RS, Wallen EM et al (2014) Metabolic syndrome as a predictor for postoperative complications after urologic surgery. Urology 83:1051–1059

    Article  PubMed  Google Scholar 

  25. Hammarsten J, Hogstedt B (1999) Clinical, anthropometric, metabolic and insulin profile of men with fast annual growth rates of benign prostatic hyperplasia. Blood Press 8:29–36

    Article  CAS  PubMed  Google Scholar 

  26. Ponholzer A, Madersbacher S (2007) Lower urinary tract symptoms and erectile dysfunction; links for diagnosis, management and treatment. Int J Impot Res 19:544–550

    Article  CAS  PubMed  Google Scholar 

  27. Shenfeld OZ, Meir KS, Yutkin V, Gofrit ON, Landau EH, Pode D (2005) Do atherosclerosis and chronic bladder ischemia really play a role in detrusor dysfunction of old age? Urology 65:181–184

    Article  PubMed  Google Scholar 

  28. Lloyd-Jones Donald M (2014) Niacin and HDL Cholesterol-time to face facts. N Engl J Med 371:271–273

    Article  PubMed  Google Scholar 

  29. Berger AP, Bartsch G, Deibl M, Alber H, Pachinger O, Fritsche G et al (2006) Atherosclerosis as a risk factor for benign prostatic hyperplasia. BJU Int 98:1038–1042

    Article  PubMed  Google Scholar 

  30. Carignan A, Roussy JF, Lapointe V, Valiquette L, Sabbagh R, Pépin J (2012) Increasing risk of infectious complications after transrectal ultrasound-guided prostate biopsies: Time to reassess antimicrobial prophylaxis? Eur Urol 62:453–459

    Article  PubMed  Google Scholar 

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standard

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the Declaration of Helsinki 1964 and its later amendments or comparable ethical standards.

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Correspondence to Cahit Sahin.

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Sahin, C., Eryildirim, B., Cetinel, A.C. et al. Does metabolic syndrome increase the risk of infective complications after prostate biopsy? A critical evaluation. Int Urol Nephrol 47, 423–429 (2015). https://doi.org/10.1007/s11255-014-0904-x

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  • DOI: https://doi.org/10.1007/s11255-014-0904-x

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