Increasing Hospital Admission Rates for Urological Complications After Transrectal Ultrasound Guided Prostate Biopsy

Received 15 July 2009 published online 19 January 2010.

Refers to article:

Prostate Biopsy: A Risk-Benefit Analysis , 19 January 2010
Stacy Loeb
The Journal of Urology
March 2010 (Vol. 183, Issue 3, Pages 852-853)
Full Text | Full-Text PDF (102 KB)

Purpose

Transrectal ultrasound guided prostate biopsy is widely used to confirm the diagnosis of prostate cancer. The technique has been associated with significant morbidity in a small proportion of patients.

Materials and Methods

We conducted a population based study of 75,190 men who underwent a transrectal ultrasound guided biopsy in Ontario, Canada, between 1996 and 2005. We used hospital and cancer registry administrative databases to estimate the rates of hospital admission and mortality due to urological complications associated with the procedure.

Results

Of the 75,190 men who underwent transrectal ultrasound biopsy 33,508 (44.6%) were diagnosed with prostate cancer and 41,682 (55.4%) did not have prostate cancer. The hospital admission rate for urological complications within 30 days of the procedure for men without cancer was 1.9% (781/41,482). The 30-day hospital admission rate increased from 1.0% in 1996 to 4.1% in 2005 (p for trend <0.0001). The majority of hospital admissions (72%) were for infection related reasons. The probability of being admitted to hospital within 30 days of having the procedure increased 4-fold between 1996 and 2005 (OR 3.7, 95% CI 2.0–7.0, p <0.0001). The overall 30-day mortality rate was 0.09% but did not change during the study period.

Conclusions

The hospital admission rates for complications following transrectal ultrasound guided prostate biopsy have increased dramatically during the last 10 years primarily due to an increasing rate of infection related complications.

Key Words: mass screening, prostatic neoplasms, biopsy, adverse effects

Abbreviations and Acronyms: CIHI, Canadian Institute of Health Information, OHIP, Ontario Health Insurance Plan, SES, socioeconomic status, TRUS, transrectal ultrasound

a Division of Urology, Sunnybrook Research Institute, Toronto, Ontario, Canada

b Division of General Surgery, Sunnybrook Research Institute, Toronto, Ontario, Canada

c Department of Microbiology and Division of Infectious Diseases, Sunnybrook Research Institute, Toronto, Ontario, Canada

d Department of Radiation Oncology, Sunnybrook Research Institute, Toronto, Ontario, Canada

e Division of Molecular and Cellular Biology, Sunnybrook Research Institute, Toronto, Ontario, Canada

f Division of General Internal Medicine, St. Michael's Hospital, Toronto, Ontario, Canada

g Institute of Clinical Evaluative Sciences, University Health Network, Toronto, Ontario, Canada

h Division of Urology, University Health Network, Toronto, Ontario, Canada

i Division of General Surgery, University Health Network, Toronto, Ontario, Canada

j Department of Public Health Sciences, University of Toronto, Toronto, Ontario, Canada

k Department of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada

Correspondence: Division of Urology, Sunnybrook Health Sciences Centre, 2075 Bayview Ave., Room MG-406, Toronto, Ontario, Canada M4N 3M5 (telephone: 416-480-5075; FAX: 416-480-6934)

Study received research ethics board approval.

Supported by National Cancer Institute Grant 010294 and the Canadian Institute of Health Research.

Supplementary material for this article can be obtained at www.prostaterisk.ca.

See Editorial on page 852.

Editor's Note: This article is the fourth of 5 published in this issue for which category 1 CME credits can be earned. Instructions for obtaining credits are given with the questions on pages 1262 and 1263.

† Nothing to disclose.

‡ Financial interest and/or other relationship with Abbott, AstraZeneca, Aventis, Merck and GSK.

PII: S0022-5347(09)02932-2

doi:10.1016/j.juro.2009.11.043

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