Morbidity of ultrasound-guided transrectal core biopsy of the prostate without prophylactic antibiotic therapy. A prospective study in 415 cases

Objective To evaluate prospectively the incidence of complications following transrectal core biopsy of the prostate without prophylactic antibiotic therapy. Patients and methods The study comprised 426 consecutive patients who underwent transrectal core biopsies of the prostate guided by transrectal ultrasonography (TRUS). The patients were requested to return a completed questionnaire 2 weeks after the examination; 415 patients (97.4%) did so. Results The predominant complications were haematuria (49.6%) and rectal bleeding (21.7%), which did not require treatment. Twelve patients (2.9%) developed fever and II of these were treated successfully with antibiotics. One recovered without treatment. One patient had urinary retention. Conclusion In this study, most complications following TRUS-guided biopsies were minor and required no treatment. Automated needle biopsy is an acceptable option for biopsy of the prostate and does not provoke the need for prophylactic antibiotic therapy. However, it is mandatory to counsel patients before biopsy and to monitor the infection rate. The ultimate need for antibiotic prophylaxis remains to be determined.