Prostate biopsy is one of those things that is usually performed with the help of the transrectal route around the world. One thing to keep in mind is that the complications of infections are likely to occur in up to 7% of cases. Thus, alternative strategies tend to decrease the likelihood of infectious complications. For a study, the aim was to evaluate the intrarectal povidone-iodine cleansing effectiveness along with the formalin disinfection of the tip of the needle to decrease the infectious complications after prostate biopsy through a transrectal ultrasound guide.

With prospective, single-center, phase III trials, patients undergoing transrectal ultrasound-guided prostate biopsy were randomized in 1:1 to rectal mucosa cleansing. Researchers took the help of 10% povidone-iodine solution with needle tip disinfection and gloved index finger by immersing it in 10% formalin solution before each control vs. puncture group.

The primary endpoint was the infectious complication rate defined as one or more of the following events, including sepsis, urinary tract infection, or fever.

A randomized group intervention of 633 was done, and out of those, 623 were in the control group. The infectious complication rate was 6.4% in the control group  (RR 0.61; 95% CI 0.36-0.99; P = .049) and 3.9% in the intervention group. The sepsis rate, urinary tract infection, and fever were 0.3% vs 0.5% (P = .646), 2.3% vs 4.1% (P = .071), and 1.3% vs 1.9% (P = .443), respectively. The positive urine culture rate was 9% in the control group and 5.2% in the intervention group (RR 0.57; P = .015). 

The association of the intrarectal povidone-iodine cleansing plus formalin disinfection of the biopsy needle tip. It reduces infectious complications after transrectal prostate biopsy.

Reference: auajournals.org/doi/10.1097/JU.0000000000002910