Non-infectious complications following transrectal prostate needle biopsy – Outcomes from over 8000 procedures

Adrian Sosenko, Russell G. Owens, Ae Lim Yang, Ahmad Alzubaidi, Thomas Guzzo, Edouard Trabulsi, John Danella, Gregory Diorio, Adam Reese, Jeffrey Tomaszewski, Serge Ginzburg, Marc Smaldone, Claudette Fonshell, Kaynaat Syed, Bruce Jacobs, Eric A. Singer, Jay D. Raman

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Background: Prostate needle biopsy (PNB) remains the referent standard for diagnosing prostate cancer. Contemporary data highlight an increase in PNB-related infections particularly when performed transrectally. Non-infectious complications, however, may similarly contribute to biopsy-related morbidity. We review the incidence and predictors of non-infectious complications following transrectal PNB in a large statewide quality registry. Methods: Transrectal ultrasound-guided prostate needle biopsies performed between 2015 and 2018 were retrospectively reviewed. The incidence and distribution of non-infectious complications were annotated. Clinical, demographic, and biopsy variables of interest were evaluated by logistic regression for potential association with specific types of non-infectious complications. Results: Of 8,102 biopsies, 277 (3.4%) biopsies had reported post-procedure complications including 199 (2.5%) non-infectious and 78 (0.9%) infectious. Among the non-infectious complications, the most common events included urinary or rectal bleeding (74; 0.9%), urinary retention (70, 0.9%), vasovagal syncope (13, 0.2%), and severe post-operative pain (10, 0.1%). Approximately 56% of these non-infectious complications required an Emergency Department visit (111/199) and 27% (54/199) hospital admission for monitoring. Increasing transrectal ultrasound prostate volume was associated with post-procedure urinary retention (Odds ratio (OR) 1.07, 1.02–1.11, p = 0.002). No specific variables noted association with post-biopsy bleeding. Conclusion: Non-infectious complications occurred 2.5 times more often than infectious complications following transrectal ultrasound prostate needle biopsies. Larger prostate size was associated with a greater risk of post-procedure urinary retention. These data originating from experience from over 100 urologists across different health systems provide an important framework in counseling patients regarding expectations following transrectal prostate biopsy.

Original languageEnglish (US)
Pages (from-to)158-161
Number of pages4
JournalProstate International
Issue number3
StatePublished - Sep 2022

All Science Journal Classification (ASJC) codes

  • Urology


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