Prostate Biopsy Complications Deter Patients From Re-Biopsy

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Study participants with acute urinary retention after TRUS-guided prostate biopsy were 4.5 times more likely to skip a recommended re-biopsy than men who had no initial biopsy-related complications.
Study participants with acute urinary retention after TRUS-guided prostate biopsy were 4.5 times more likely to skip a recommended re-biopsy than men who had no initial biopsy-related complications.

Men who experience a complication following transrectal ultrasound (TRUS)-guided prostate biopsy are less likely to comply with clinician requests for re-biopsy, new study findings suggest.

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Of 4939 men (aged 50 to 75 years) who underwent prostate biopsy at 2 years in the REDUCE trial, 5.3% experienced a complication such as hematuria, urinary tract infection (UTI), acute urinary retention (AUR), or hematospermia. In multivariable analysis, having any complication was associated with significant 65% greater odds of avoiding recommended re-biopsy at 4 years. Previous biopsy-related AUR, UTI, and hematospermia were associated with significant 4.5, 2.6, and 1.8 times greater odds of noncompliance, respectively. Results were hematuria were not significant.

“In men undergoing repeat prostate biopsy, a previous biopsy-related complication and the type of complication were associated with lower compliance with re-biopsy schemes,” Daniel Moreira, MD, MHS, of the University of Illinois at Chicago, and colleagues summarized in an online report published in the Journal of Urology. “Patients experiencing biopsy-related complications are ideal candidates to receive interventions regarding the importance of prostate re-biopsy to prevent noncompliance.” The investigators suggested urologists explain how the benefits of re-biopsy outweigh the risks. Whether these results apply to patients on active surveillance is unclear.

Reference

Schwarzman LS, Abern MR, Garvey DF, Andriole GL, Freedland SJ, and Moreira DM. The association of previous prostate biopsy-related complications and the type of complication with patient compliance with re-biopsy scheme. J Urol. DOI: 10.1016/j.juro.2018.06.018

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