Surgical infections · 2025
Clinical Value of Routine Urine Culture in Non-Febrile Patients on Transperineal Prostate Biopsy.
СтатьяНазвание и аннотация: Перевод в очереди
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Pan Xianwei, Wen Lijie
Аннотация
PURPOSE: Transperineal prostate biopsy has been widely recommended because of its low post-operative complications. We aim to evaluate the clinical value of routine urine culture in non-febrile patients on transperineal prostate biopsy, particularly in terms of infection-related complications and cancer detection rates.
MATERIALS AND METHODS: A retrospective analysis was conducted on patients who met the following inclusion criteria: (a) no fever, and (b) no antimicrobials in the 7-day period prior to transperineal prostate biopsy. Patients were categorized based on urine culture results: negative urine culture group, urine culture contamination group, and positive urine culture group.
RESULTS: Infectious complications were more common in the positive urine culture group (11.8%, p < 0.05) than the others. There were no sepsis or death events. In multi-variable logistic regression analysis, patients in the positive urine culture group had 6.54 times higher the odds of developing infection-related complications compared to those in the negative group (95% confidence interval [CI]: 1.805-23.731, p = 0.004). The cancer detection rate was higher in the negative urine culture group than the positive group (49% vs. 33.8%, p < 0.05). Patients in the negative urine culture group had 2.12 times higher the odds of cancer detection rate than patients in the positive group (95% CI: 1.175-3.83, p = 0.013).
CONCLUSION: Urine culture prior to prostate biopsy remains clinically relevant. Furthermore, for patients with positive urine culture, who are non-febrile and have not received antibiotic treatment or prophylaxis, it would be meaningful to explore whether attempted antibiotic therapy could improve prostate cancer detection rates or avoid unnecessary prostate biopsies.
MATERIALS AND METHODS: A retrospective analysis was conducted on patients who met the following inclusion criteria: (a) no fever, and (b) no antimicrobials in the 7-day period prior to transperineal prostate biopsy. Patients were categorized based on urine culture results: negative urine culture group, urine culture contamination group, and positive urine culture group.
RESULTS: Infectious complications were more common in the positive urine culture group (11.8%, p < 0.05) than the others. There were no sepsis or death events. In multi-variable logistic regression analysis, patients in the positive urine culture group had 6.54 times higher the odds of developing infection-related complications compared to those in the negative group (95% confidence interval [CI]: 1.805-23.731, p = 0.004). The cancer detection rate was higher in the negative urine culture group than the positive group (49% vs. 33.8%, p < 0.05). Patients in the negative urine culture group had 2.12 times higher the odds of cancer detection rate than patients in the positive group (95% CI: 1.175-3.83, p = 0.013).
CONCLUSION: Urine culture prior to prostate biopsy remains clinically relevant. Furthermore, for patients with positive urine culture, who are non-febrile and have not received antibiotic treatment or prophylaxis, it would be meaningful to explore whether attempted antibiotic therapy could improve prostate cancer detection rates or avoid unnecessary prostate biopsies.