The following is a summary of “Infectious And Non-Infectious Complications Following Prostate Biopsy: A Randomized Clinical Trial,” published in the April 2023 issue of Urology by Mian et al.

The objective of this study was to compare the incidence of infectious and non-infectious complications following prostate biopsy via transrectal (TR-Bx) or transperineal (TP-Bx) approaches. Despite the ongoing debate over which approach is superior, no definitive consensus exists within clinical guidelines, prompting this randomized clinical trial (ClinicalTrials.gov: NCT04081636) aiming to address this knowledge gap. A total of 763 men undergoing prostate biopsy were randomly assigned to either TR-Bx or TP-Bx procedures performed under local anesthesia. 

The primary outcome was the 30-day incidence of composite infectious complications, such as fever, antibiotic prescriptions, infections, sepsis, emergency visits, or hospitalizations, while secondary outcomes included composite non-infectious complications, including urinary retention, hemorrhage requiring intervention, or unplanned healthcare utilization. Results from 718 completed procedures and follow-ups revealed that both TR-Bx (n=351) and TP-Bx (n=367) exhibited similar rates of infectious (2.6% vs. 2.7%, respectively; p=0.99) and non-infectious complications (1.7% vs. 2.2%, respectively; p=0.79) within 30 days post-biopsy. Fever was the most frequently reported complication, with no significant between-group differences observed in the occurrence of specific outcomes. This study highlights that both TR-Bx and TP-Bx procedures carry comparable risks of complications in men undergoing prostate biopsies for cancer detection. 

Source: auajournals.org/doi/10.1097/JU.0000000000003426.03