Complication of trans-rectal prostate biopsy based on Clavien index: 5 years of experience

https://doi.org/10.19106/JMedSci005303202107

Adhitya Fajar Prasetya(1*), Johan Renaldo(2)

(1) Department of Urology, Faculty of Medicine, Universitas Airlangga/Dr. Soetomo General Hospital, Surabaya, Indonesia
(2) Department of Urology, Faculty of Medicine, Universitas Airlangga/Dr. Soetomo General Hospital, Surabaya, Indonesia
(*) Corresponding Author

Abstract


Trans-rectal prostate biopsy has become the gold standard for early diagnosis
of prostate cancer in developing countries. Despite its low risk, there are
some post-procedural complications. The complications are classified by
using a modified Clavien-Dindo system. The study aimed to recognize
complications of trans-rectal prostate biopsy procedure by using Clavien-
Dindo classification index. All patients undergoing trans-rectal prostate
biopsy procedure in the Department of Urology, Dr. Soetomo General Hospital
between January 2015-December 2019, were retrospectively analyzed in
terms of post-procedural complaints, underlying comorbidities and ongoing
additional examinations. The complaints were compiled into Clavien-Dindo
classification. Univariate analysis of various predictors of post-procedural
complications was also conducted. It was found 98 complication events from
400 patients (24.5%). Most complications were 1st degree (dysuria, hematuria,
urinary retention, fever, rectal pain and bleeding, erectile dysfunction, and
constipation).  In univariate analysis, positive results of urinary culture
correlated to the emergence of post-procedural complications. In conclusion,
the incidence of post-trans-rectal prostate biopsy complication in Dr. Soetomo
General Hospital reached 24.5%. From all of the risk factors, positive urinary
culture is related to the post-biopsy complication. Most complications are in
the 1st grade of Clavien index, suggesting that the procedure is relatively safe
and has a low risk

Keywords


Clavien; complication; trans-rectal prostate biopsy; dysuria; hematuria

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References

Wein AJ, Kavoussi LR, Partin AW, Peters CA. Campbell-Walsh Urology: Eleventh Edition. Philadelphia: Elsevier, 2020.

Bissada NK. Prostate Biopsy. Rijeka: InTech, 2011.

Mottet N, Cornford P, Van den Bergh RCN et al. EAU-EANM-ESTRO-ESUR-SIOG Guidelines on Prostate Cancer. Arnhem: EAU Guidelines Office, 2020.

Tyng CJ, Sampaio Maciel MK, Lima Moreira B, Kawaoka Matushita JP, Vieira Bitencourt AG, Brites Poli MR. Preparation and management of complications in prostate biopsies. Radiol Bras 2013; 46 (6): 367-71.

Raheem OA, Casey RG, Galvin DJ et al. Discontinuation of anti-coagulant or anti-platelet therapy for trans-rectal ultrasound-guided prostate biopsies: a single center experience. Korean J Urol 2012; 53: 234-9.

Miyamoto S, Nakao J, Higashino T, Yoshimoto S, Hayashi R, Sakuraba M. Clavien-Dindo classification for grading complications after total pharyngolaryngectomy and free jejunum transfer. PLoS ONE 2019; 14 (9): e0222570.

Katayama H, Kurokawa Y, Nakamura K et al. Extended Clavien-Dindo classification of surgical complications: Japan Clinical Oncology Group post-operative complications criteria. Surg Today 2016; 46: 668-85.

Shahait M, Degheili J, El-Merhi F, Tamim H, Nasr R. Incidence of sepsis following transrectal ultrasound guided prostate biopsy at a tertiary-care medical center in Lebanon. Int’l Braz J Urol 2016; 42: 60-8.

Singh AK, Shukla PK, Khan SW, Rathee VS, Dwivedi US, Trivedi S. Using the modified Clavien grading system to classify complications of percutaneous nephrolithotomy. Curr Urol 2017; 11: 79-84.

Mitropoulos D, Artibani W, Biyani CS, Jensen JB, Rouprêt M, Truss M. Validation of the Clavien-Dindo grading system in urology by the European Association of Urology Guidelines ad hoc panel. Eur Urol Focus 2018; 4 (4): 608-13.

Bolliger M, Kroehnert J-A, Molineus F, Kandioler D, Schindl M, Riss P. Experiences with the standardized classification of surgical complications (Clavien-Dindo) in general surgery patients. Eur Surg 2018; 50: 256-61.

Oh KT, Koo KC, Chung BH, Lee KS. Comparison of prostate cancer detection rates of various prostate cancer detection rates of various prostate biopsy methods for patients with prostate-specific antigen levels of <10.0% ng/ml in real-world practice. Invest Clin Urol 2020; 61: 28-34.

Chen PH, Chang CP, Wang BF et al. Standardized protocol in preventing postoperative infectious complications after transrectal ultrasound-guided biopsy: a retrospective study of 246 patients. Urol Sci 2016; 27: 140-3.

Yanaral F, Özgör F, Savun M et al. Impact of prostate needle biopsy on erectile function. Med Bull Haseki 2019; 57: 47-50.

Taneja SS, Shah O. Taneja’s Complication of Urologic Surgery: Diagnosis, Prevention, and Management (edisi 5). Philadelphia: Elsevier, 2018.

Wibisono, Soebadi DM, Alif S, Pudjirahardjo WJ. Changes in erectile function before and after prostate biopsy. Indonesian J Urol 2013; 20 (2): 60-5.

Loeb S, Vellekoop A, Ahmed HU et al. Systematic review of complications of prostate biopsy. Eur Urol 2013; 64: 876-92.

Efesoy O, Bozlu M, Çayan S, Akbay E. Complications of transrectal ultrasound-guided 12-core prostate biopsy: a single center experience with 2049 patients. Turkish J Urol 2013: 39 (1): 6-11.

Bruyère F, D'Arcier BF, Boutin J-M, Haillot O. Is urine culture routinely necessary before prostate biopsy? Prostate Canc Prostatic Dis 2010; 13: 260-2.

Hruza M, Weiss HO, Pini G et al. Complications in 2200 consecutive laparoscopic prostatectomies: standardized evaluation and analysis of learning curves. Eur Urol 2010; 58: 733-41.

Huang H, Wang W, Lin T et al. Comparison of the complications of traditional 12 cores trans-rectal prostate biopsy with image fusion guided trans-perineal prostate biopsy. BMC Urol 2016; 16: 68.

Nóbrega de Jesus CM, Corrêa LA, Padovani CR. Complications and risk factors in transrectal ultrasound-guided prostate biopsies. São Paulo Med J 2006; 124 (4): 198-202.

Elkoushy M, Luz MA, Benidir T, Aldousari S, Aprikian AG, Andonian S. Clavien classification in urology: is there concordance among post-graduate trainees and attending urologists? Can Urol Assoc J 2013; 7 (5-6): 179-84.



DOI: https://doi.org/10.19106/JMedSci005303202107

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