Prostate Biopsy Poses Risks, Study Finds

A test to help in the fight against prostate cancer might actually pose significant risks. Prostate biopsies have been linked to increased complications that require hospitalization, said Health Imaging, citing an online study published in the November issue of Journal of Urology.

Edward Schaeffer, MD, PhD, senior investigator, and his peers from Johns Hopkins Medical Institutions in Baltimore, Maryland said they observed a 6.9 percent hospitalization rate within the first 30 days of biopsy versus a rate of 2.9 among a control group of men who did not undergo prostate biopsy, said Health Imaging. “Together these findings highlight the importance of careful patient selection and counseling regarding prostate biopsy,” the authors concluded.

The findings mean that nearly 7% of men 65 and older who undergo prostate biopsy must be hospitalized within one month of their procedures, said USA Today, which noted that only 3% of the control group required hospitalization. “The overall hospitalization rate is about twice as high as the average rate of hospitalization for the average person,” said Dr. Schaeffer, wrote USA Today.

This study, wrote Health Imaging, was the largest ever on Medicare records of men in this age group who underwent prostate biopsies in the past 20 years. The data was from over 17,400 men and covered test years 1991 to 2007 and was compared to the control cohort of 134,977 men with “similar characteristics,” said Health Imaging. The team reviewed hospital admissions and did not include men whose complications were treated in an emergency department or on outpatient basis.

Complications included bleeding, infection, and recurrence of underlying medical conditions, including heart failure or breathing disorders, said Health Imaging.

Prostate biopsy has long been considered a benign procedure and involves the use of a transrectal ultrasound. The authors believe it’s possible that rectal bacteria might be carried into the prostate, increasing potential infection risks, said Health Imaging. As a matter-of-fact, infection-related complications increased steadily during the study period with a rate of under 0.5 percent in 1991, said Health Imaging. The rate remained virtually unchanged for about 9 years when, in 2000, rates for infection-related complications increased to over 1.2 percent in 2007.

“A likely explanation for the increase in infectious complications is increasing antimicrobial resistance,” wrote the authors, who said the American Urological Association recommends anti-microbial prophylaxis for all prostate biopsy patients, reported Health Imaging. “That means that something about the biopsy is causing people to get sick and need admission to the hospital. We’ve always thought of prostate biopsy as a simple outpatient procedure, but it does stress the body,” said Schaeffer, wrote USA Today.

Prostate cancer, one of the most common causes of cancer in American men, is typically diagnosed via transrectal biopsy, which involves the physician guiding the needle through the rectum to obtain a prostate sample, explained USA Today. The study revealed that more than 1 million prostate biopsies are conducted annually on men insured by Medicare, said USA Today.

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