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[Hospitalization rate in relation to severe complications of transrectal prostate biopsy: About 2715 patients biopsied].

[Hospitalization rate in relation to severe complications of transrectal prostate biopsy: About 2715 patients biopsied].
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Tamarelle B, Perrin P, Devonec M, Paparel P, Ruffion A,


Tamarelle B, Perrin P, Devonec M, Paparel P, Ruffion A, (click to view)

Tamarelle B, Perrin P, Devonec M, Paparel P, Ruffion A,

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Progres en urologie : journal de l’Association francaise d’urologie et de la Societe francaise d’urologie 2016 Oct 4() pii 10.1016/j.purol.2016.09.062

Abstract
MAIN OBJECTIVE
To identify hospitalizations directly related to a complication occurring within 30 days following a transrectal prostate biopsy (PBP).

SECONDARY OBJECTIVES
Overall hospitalization rates, mortality rates, potential predisposing factors for complications.

PATIENTS AND METHODS
Single-center study including all patients who underwent PBP between January 2005 and January 2012. Any hospitalization occurring within 30 days of the PBP for urgent motive was considered potentially attributable to biopsy. We identified the reason for hospitalization with direct complications (urinary infection or fever, rectal bleeding, bladder caillotage, retention) and indirect (underlying comorbidities decompensation) of the biopsy. The contributing factors were anticoagulant or antiplatelet treatment well as waning immunity factors (corticosteroid therapy, HIV, chemotherapy or immunodulateur).

RESULTS
Among 2715 men who underwent PBP, there were 120 (4.4%) hospitalizations including 28 (1.03%) caused by the biopsy. Twenty-five (0.92%) were related to a direct complication of biopsy: 14 (56%) for urinary tract infection or fever including 1 hospitalization in intensive care, 5 (20%) for rectal bleeding which required several transfusions 1, 10 (40%) urinary retention and 3 (0.11%) for an indirect complication (2 coronary syndromes and 1 respiratory failure). Several direct complications were associated in 3 cases. Only two hospitalizations associated with rectal bleeding were taking an antiplatelet or anticoagulant. There was no association between hospitalization for urinary tract infections and a decreased immune status. The first death observed in our study occurred at D31 of pulmonary embolism (advanced metastatic patient with bladder cancer). Twenty (60.6%) patients urgently hospitalized did not have prostate cancer.

CONCLUSIONS
Within this large sample of patients the overall rate of hospitalization due to the realization of a PBP was 1%. It has not been found predictive of complications leading to hospitalization.

LEVEL OF EVIDENCE
4.

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